Medical management of brain metastases and leptomeningeal disease in patients with breast carcinoma

Future Oncol. 2018 Feb;14(4):391-407. doi: 10.2217/fon-2017-0255. Epub 2018 Jan 18.

Abstract

Breast cancer is the most common malignancy among women and accounts for the second highest number of cancer-related deaths. With patients surviving longer due to advances in systemic control, the incidence of CNS involvement is increasing; however, the management of CNS metastases has not undergone parallel advancements. The blood-brain barrier limits the efficacy of most systemic chemotherapies, and the utilization of surgery and radiation beyond first-line therapy is limited. We will explore the recent developments in the medical management of breast cancer brain metastasis. Beyond traditional chemotherapy, we will also discuss targeted therapies and immunotherapies which may provide a survival benefit to this population and thus, offer further treatment options and a path for future research and treatment advances.

Keywords: brain metastasis; breast cancer; chemotherapy; immunotherapy; leptomeningeal disease.

Publication types

  • Review

MeSH terms

  • Blood-Brain Barrier / metabolism
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / epidemiology
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / pathology
  • Disease Management*
  • Female
  • Humans
  • Immunotherapy / methods
  • Meningeal Neoplasms / drug therapy*
  • Meningeal Neoplasms / epidemiology
  • Meningeal Neoplasms / pathology