Radiat Oncol J.  2016 Mar;34(1):1-9. 10.3857/roj.2016.34.1.1.

Brain metastasis in human epidermal growth factor receptor 2-positive breast cancer: from biology to treatment

• Koo T
• Kim IA

• KMID: 2316750
• DOI: http://doi.org/10.3857/roj.2016.34.1.1

Abstract

Overexpression of human epidermal growth factor receptor 2 (HER2) is found in about 20% of breast cancer patients. With treatment using trastuzumab, an anti-HER2 monoclonal antibody, systemic control is improved. Nonetheless, the incidence of brain metastasis does not be improved, rather seems to be increased in HER2-positive breast cancer. The mainstay treatment for brain metastases is radiotherapy. According to the number of metastatic lesions and performance status of patients, radiosurgery or whole brain radiotherapy can be performed. The concurrent use of a radiosensitizer further improves intracranial control. Due to its large molecular weight, trastuzumab has a limited ability to cross the blood-brain barrier. However, small tyrosine kinase inhibitors such as lapatinib, has been noted to be a promising agent that can be used as a radiosensitizer to affect HER2-positive breast cancer. This review will outline general management of brain metastases and will focus on preclinical findings regarding the radiosensitizing effect of small molecule HER2 targeting agents.

Keyword

Breast neoplasms; Neoplasm metastasis; ErbB-2 receptor; Radiotherapy; Trastuzumab; Lapatinib

MeSH Terms

Biology*
Blood-Brain Barrier
Brain*
Breast Neoplasms
Epidermal Growth Factor*
Humans*
Incidence
Molecular Weight
Neoplasm Metastasis*
Protein-Tyrosine Kinases
Radiation-Sensitizing Agents
Radiosurgery
Radiotherapy
Receptor, Epidermal Growth Factor*
Receptor, erbB-2
Trastuzumab
Epidermal Growth Factor
Protein-Tyrosine Kinases
Radiation-Sensitizing Agents
Receptor, Epidermal Growth Factor
Receptor, erbB-2