Can we prevent brain metastases in breast cancer?

Nancy Lin, MD, Dana-Farber Cancer Institute, Boston, MA, discusses the latest progress in developing strategies to prevent brain metastases in patients with breast cancer. Prevention in early-stage disease remains a challenge, with clinical trials of trastuzumab, pertuzumab, lapatinib, and trastuzumab emtansine (TDM1) all failing to provide evidence of efficacy against central nervous system (CNS) relapse. More progress has been seen in the metastatic HER2-postive breast cancer setting. Two recent randomized trials in advanced HER2-positive breast cancer have shown promising CNS results: the Phase III NALA trial (NCT01808573) of neratinib plus capecitabine and the Phase II HER2CLIMB trial (NCT02614794) of tucatinib with capecitabine and trastuzumab. This interview took place during the 17th St. Gallen International Breast Cancer Conference.