Breast cancer
Brain metastases in patients with HER2+ breast cancerHermione (78 years old)
Hermione, 78 years old, complains of an intense headache since 3 weeks.
Assessment summary
- Medical history: diagnosis of HER2+ metastatic breast cancer 6 years ago
- Prior systemic therapy (3 lines):
- Paclitaxel + trastuzumab + pertuzumab
- T-DM1
- Lapatinib + capecitabine (ongoing)
- Prior local treatment: SRS of 2 frontal brain lesions after 2nd-line of systemic treatment
- Prior systemic therapy (3 lines):
- ECOG PS: 2
- Brain MRI: extensive linear leptomeningeal disease (LMD)
- Cerebro-spinal fluid (CSF) analysis: elevated protein (75 mg/dl), presence of pathologic cells
- No response of the patient’s symptoms on steroids