title: Therapeutic approach to the management of HER2-positive breast cancer metastatic to the brain.
abstract: HER2 positive breast cancers have been shown to have a greater propensity to metastasise to the brain. This may be due to several reasons, including the creation of a "sanctuary-site" for tumour in the brain following trastuzumab therapy. Elucidating the mechanism of this phenomenon may aid the prevention or intervention and treatment of such metastases, but research is limited by the deficiency and diminished access of CNS tissue. However, CNS penetrable HER2 receptor antagonists such as lapatinib and intrathecal administration of trastuzumab might benefit patients, and are worthy of further investigation. New avenues of molecular approach have focused on manipulating signal transduction system involved in HER2 function. The importance of systemic therapies and those targeted to metastatic lesions is emphasised and evaluated here.
authors.affiliation: Ophthalmology Department, Bradford Royal Infirmary, Bradford, West Yorkshire BD9 6RJ, UK.
authors.forename: Ajay
authors.initials: A
authors.lastname: Patil
authors.affiliation: School of Electrical and Electronic Engineering, University of Newcastle upon Tyne and Institute for Molecular Medicine, Huntington Beach, CA, UK. Electronic address: gajanan.sherbet@ncl.ac.uk.
authors.forename: G V
authors.initials: GV
authors.lastname: Sherbet
mesh_terms: D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D001943:Breast Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D019468:Disease Management; D005260:Female; D006801:Humans; D000077341:Lapatinib; D058990:Molecular Targeted Therapy; D058953:Neural Stem Cells / Q000378:metabolism / Q000637:transplantation; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D011799:Quinazolines / Q000494:pharmacology / Q000627:therapeutic use; D011878:Radiotherapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000077341:Lapatinib; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab
keywords: Brain metastases; Breast cancer; HER2; Signalling pathways