Targeted therapy offers new weapon against HER2+ breast cancer with LM

This study (NCT03501979) examined the drug combination of tucatinib (Tukysa), trastuzumab (Herceptin), and capecitabine for HER2-positive breast cancer with leptomeningeal metastases (LM). Treatment options for LM are limited and survival rates are poor.

The researchers enrolled 17 patients with HER2-positive breast cancer and newly diagnosed LM. All patients received the drug combination in cycles. Median overall survival was 10 months, which is longer than the survival typically seen with LM. Of 13 patients eligible for response assessment, nearly 40% achieved an objective response. All 13 patients experienced some level of clinical benefit, including stable disease or improvement in symptoms. Patients with neurological deficits showed improvement in more than half of the cases. Quality of life and symptom burden also improved significantly.

This is the first study to demonstrate clear benefits of systemic treatment for LM in HER2-positive breast cancer. These results suggest that such treatments may be a good initial approach for the management of LM, potentially improving patient outcomes.

Here, Mina Lobbous, MD, MPH, an oncologist in the Brain Tumor and Neuro-Oncology Center at Cleveland Clinic, discusses this patient population and the study results presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

Transcription:

So, leptomeningeal carcinomatosis, as you know, has a very poor prognosis. And unfortunately, there is a group of patients that are excluded from most clinical trials. The challenges of IOC, leptomeningeal carcinomatosis, has a very poor prognosis or a term of a few weeks, unfortunately, and this group of patients is excluded from most clinical trials. So, the trial represents the first prospective study, the first prospective study, that looks at this disease, as you know, as the more systemic treatment works the better the longer the patients are left, and the more frequent we will see like electrons Gol, owners, odunsi, leptomeningeal carcinomatosis, and otherwise, patients who had good functional status and

So the Capeside combination increased the tuza card and is effective and the patient was cured of meningeal carcinomatosis. Of her two positive breast cancers, the median overall survival was about 10 months, and we have as a data cutoff time. So we are patients who remain alive.