Breast cancer
Brain metastases in patients with HER2+ breast cancer

Teresa (59 years old)

Teresa, 59 years old, runs a travel agency and convinces a lot of her clients about the beauty of Asia. She was earlier diagnosed with early breast cancer.

  • No relevant comorbidities
  • 4 years ago: diagnosed with early breast cancer
    • ER 0%, PgR 0%, HER2 IHC 3+
    • Received adjuvant anthracycline/taxane and trastuzumab
  • 1 year ago: diagnosis metastatic breast cancer (bone, lymph nodes, brain)
    • Symptomatic: bone pain, headache, nausea
    • Local treatment brain metastases: WBRT
    • Systemic treatment: taxane + trastuzumab + pertuzumab
    • Good response in brain, partial response of extracranial disease
  • Now, progressive disease:
    • Progression of some of the bone lesions and new liver lesion
    • Progression in 1 existing brain lesion and 1 new brain lesion
    • Asymptomatic
    • ECOG PS: 1

Which of the following treatment options would you choose for this patient?