The patients with HER2-positive brain metastases who received trastuzumab had no leptomeningeal metastases and exhibited a longer survival time after brain metastases compared to the HER2-positive patients who did not receive trastuzumab and the patients with HER2-negative brain metastases (P=0.0005). This results suggested that the patients treated with trastuzumab following surgery and radiotherapy for brain metastases exhibited a better prognosis. Thus, the HER2 status in brain metastases requires re-evaluation and extended trastuzumab therapy is recommended after brain metastases 1).
The use of trastuzumab in the adjuvant setting does not prevent brain metastases.
1)
Okita Y, Narita Y, Suzuki T, Arita H, Yonemori K, Kinoshita T, Fujiwara Y,
Tsuda H, Komoike Y, Nakagawa H, Tamaki Y, Tomita Y, Shibui S, Maruno M. Extended
trastuzumab therapy improves the survival of HER2-positive breast cancer patients
following surgery and radiotherapy for brain metastases. Mol Clin Oncol. 2013
Nov;1(6):995-1001. Epub 2013 Jul 29. PubMed PMID: 24649283.