Dr. Lin on Developing Systemic Therapies for Patients with Brain Metastases in HER2+ Breast Cancer

Nancy U. Lin, MD, associate professor of medicine at Harvard Medical School; associate chief of the Division of Breast Oncology, Susan F. Smith Center for Women’s Cancers; director of the Metastatic Breast Cancer Program and senior physician at Dana-Farber Cancer Institute, discusses the development of systemic therapies for the treatment of patients with metastatic HER2-positive breast cancer and brain metastases.

At least half of patients with HER2-positive metastatic breast cancer will develop brain metastases over the course of their disease, says Lin. However, there weren't any approved agents for the systemic treatment of patients with brain metastases until recently. 

Several trials evaluating HER2-directed TKIs such as lapatinib (Tykerb) and neratinib (Nerlynx) demonstrated objective responses in the central nervous system, explains Lin. However, the phase 2 HER2CLIMB study was the first randomized trial to demonstrate an overall survival benefit for patients with brain metastases.

Additionally, the study opened the discussion of including patients with brain metastases in future clinical trials, which is currently an unmet need in this space, concludes Lin.