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BCC 2021 | Upcoming research into brain metastases in breast cancer

Nancy Lin, MD, Dana-Farber Cancer Institute, Boston, MA, discusses the greatest areas of research into brain metastases in brain cancer likely to be major focuses for development in coming years. Prof. Lin highlights the need for novel therapeutic approaches and identification of risk factors for the development of brain metastases. This interview took place during the 17th St. Gallen International Breast Cancer Conference.

Transcript (edited for clarity)

For example, Sarah Sammons and Carey Anders at Duke are developing a trial for so-called secondary prevention, that is for patients who have a brain metastasis treated with SRS, and currently are continued on their systemic therapy so long as their systemic disease is under control. But there have been a lot of questions about whether we can improve upon time to CNS progression in those patients by altering their systemic regimen...

For example, Sarah Sammons and Carey Anders at Duke are developing a trial for so-called secondary prevention, that is for patients who have a brain metastasis treated with SRS, and currently are continued on their systemic therapy so long as their systemic disease is under control. But there have been a lot of questions about whether we can improve upon time to CNS progression in those patients by altering their systemic regimen. So hopefully that study will get underway within the TBCRC.

I think that some of the other areas of research, really to understand the risk factors for development of brain metastases, to see if we can really identify a truly high-risk group. Right now we look at just subtype, ER-positive, HER2-positive, triple negative, with the latter two being more likely to develop brain metastases. But especially in the adjuvant setting where even so-called high-risk patients still fortunately have a low risk of CNS relapse. In order to get that last mile in terms of reducing that risk of CNS relapse, I think we actually have to better understand how to enrich for patient population at a particularly high risk so that, we have the proper power to test intervention’s ability to reduce the risk of CNS metastasis.

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Disclosures

Clinical trial/grant funding (to institution): Genentech, Seattle Genetics, Merck, Pfizer
Consulting/advisory board: AstraZeneca, Daichii Sankyo, Puma, Prelude Therapeutics, Seattle Genetics, Denali Therapeutics, California Institute for Regenerative Medicine