Treatment of HER2/neu-positive breast cancer with brain metastases: a clinical case
G. V. Afonin,
A. E. Glukhareva,
E. I. Kupriyanova,
A. A. Sofiychuk,
А. S. Belokhvostova,
N. A. Falaleeva,
S. A. Ivanov,
A. D. Kaprin https://doi.org/10.17709/2410-1893-2026-13-2-10
EDN: TGZWDS
Abstract
Breast cancer (BC) remains one of the most common oncological diseases among women worldwide, ranking among the leading causes of both cancer incidence and mortality. The main cause of unfavorable outcomes in BC is distant metastasis. The brain is one of the most frequent sites of distant metastatic spread, which significantly complicates treatment and worsens prognosis. This is the blood–brain barrier, which limits the penetration of many chemotherapeutic agents, as well as the aggressive biology of the tumor.
This article presents a clinical case of effective use of modern targeted agents in a patient with diagnosed breast cancer who initially had an unfavorable prognosis and disease progression after previous therapy. Particular attention is paid to treatment strategy selection and the use of contemporary targeted therapies that demonstrated clinical efficacy.
The described case illustrates the potential of a personalized approach in the treatment of this category of patients, including the possibility of disease control and improvement of clinical outcomes. The analysis of the presented clinical case indicates the need for further development of systemic maintenance therapy, as well as broader implementation of targeted and combined treatment approaches. Individualization of therapeutic strategies taking into account tumor biological characteristics and prior treatment history may contribute to improved treatment efficacy and quality of life.
About the Authors
G. V. Afonin
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Grigoriy V. Afonin – Cand. Sci. (Medicine), Head of the Department of Thoracic Oncology, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-7128-2397, eLibrary SPIN: 9039-6110, AuthorID: 896307, Scopus Author ID: 57204696417, WoS ResearcherID: О-3150-2017
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
A. E. Glukhareva
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Anastasia E. Glukhareva – oncologist, Department of Thoracic Oncology, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-4122-1569, eLibrary SPIN: 6093-0578, AuthorID: 1069449
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
E. I. Kupriyanova
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Ekaterina I. Kupriyanova – pathologist, Department of Pathology, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0001-5856-9759, eLibrary SPIN: 3557-2386, AuthorID: 919978
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
A. A. Sofiychuk
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Alexander A. Sofiychuk – oncologist, Department of Anticancer Drug Therapy, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
А. S. Belokhvostova
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Аnna S. Belokhvostova – Cand. Sci. (Medicine), Head of the Department of Anticancer Drug Therapy, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
N. A. Falaleeva
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre
Obninsk, Russian Federation
Natalia A. Falaleeva – Dr. Sci. (Medicine), Head of the Department of Drug Treatment of Malignant Neoplasms, A.Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation ORCID: https://orcid.org/0000-0002-0023-4216, eLibrary SPIN: 1431-5452, AuthorID: 150522, Scopus Author ID: 21739354400
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
S. A. Ivanov
https://new.nmicr.ru/mrrc/
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation
A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation
Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
Sergey A. Ivanov – Dr. Sci. (Medicine), Corresponding Member of the RAS, Director of A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre, Obninsk, Russian Federation; Professor of the Department of Oncology and Radiology named after V.P. Kharchenko at the Medical Institute, Peoples' Friendship University of Russia, Moscow, Russian Federation ORCID: https://orcid.org/0000-0001-7689-6032, eLibrary SPIN: 4264-5167, AuthorID: 710405, Scopus Author ID: 16070399200, WoS ResearcherID: N-8221-2017
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
A. D. Kaprin
https://new.nmicr.ru
National Medical Research Radiological Centre, Obninsk, Russian Federation
National Medical Research Radiological Centre, Obninsk, Russian Federation
P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation
Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
Andrey D. Kaprin – Dr. Sci. (Medicine), Professor, Academician of the Russian Academy of Sciences, Academician of the Russian Academy of Education, Director of P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, Moscow, Russian Federation, General Director of National Medical Research Radiological Centre, Obninsk, Russian Federation, Head of the Department of Oncology and Radiology named after V.P. Kharchenko at the Medical Institute, Peoples' Friendship University of Russia, Moscow, Russian Federation ORCID: https://orcid.org/0000-0001-8784-8415, eLibrary SPIN: 1759-8101, AuthorID: 96775, Scopus Author ID: 6602709853, WoS ResearcherID: K-1445-2014
Competing Interests:
Andrey D. Kaprin is the Editor-in-Chief of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article. Sergey A. Ivanov is the Member of the Editorial Board of the Journal «Research’n Practical Medicine Journal» and one of the authors of the article.
References
1. Malignant Neoplasms in Russia in 2023. Edited by A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. Moscow: P. Hertsen Moscow Oncology Research Institute, 2024, 276 p. (In Russ.).
2. Saha A, Ghosh SK, Roy C, Choudhury KB, Chakrabarty B, Sarkar R. Demographic and clinical profile of patients with brain metastases: A retrospective study. Asian J Neurosurg. 2013 Jul;8(3):157–161. https://doi.org/10.4103/1793-5482.121688
3. Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol. 2004;22(14):2865–2872. https://doi.org/10.1200/jco.2004.12.149
4. Niikura N, Saji S, Tokuda Y, Iwata H. Brain metastases in breast cancer. Jpn J Clin Oncol. 2014;44(12):1133–1340. https://doi.org/10.1093/jjco/hyu156
5. Semiglazov VF, Manikhas AG, Semiglazova VV. Neoadjuvant Systemic Therapy for Breast Cancer. Moscow: "Аgraf" Publ., 2012, 112 p. (In Russ.).
6. Swain SM, Miles D, Kim SB, Im YH, Im SA, Semiglazov V, et al.; CLEOPATRA study group. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA): end-of-study results from a double-blind, randomised, placebo-controlled, phase 3 study. Lancet Oncol. 2020 Apr;21(4):519–530. https://doi.org/10.1016/s1470-2045(19)30863-0
7. Curigliano G, Mueller V, Borges V, Hamilton E, Hurvitz S, Loi S, et al. Tucatinib versus placebo added to trastuzumab and capecitabine for patients with pretreated HER2+ metastatic breast cancer with and without brain metastases (HER2CLIMB): final overall survival analysis. Ann Oncol. 2022 Mar;33(3):321–329. https://doi.org/10.1016/j.annonc.2021.12.005 Erratum in: Ann Oncol. 2023 Jul;34(7):630. https://doi.org/10.1016/j.annonc.2022.12.005
8. Curigliano G, Dunton K, Rosenlund M, Janek M, Cathcart J, Liu Y, Fasching PA, Iwata H. Patient-reported outcomes and hospitalization data in patients with HER2-positive metastatic breast cancer receiving trastuzumab deruxtecan or trastuzumab emtansine in the phase III DESTINY-Breast03 study. Ann Oncol. 2023 Jul;34(7):569–577. https://doi.org/10.1016/j.annonc.2023.04.516
9. Diéras V, Miles D, Verma S, Pegram M, Welslau M, Baselga J, et al. Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2017 Jun;18(6):732–742. https://doi.org/10.1016/s1470-2045(17)30312- 1 Erratum in: Lancet Oncol. 2017 Aug;18(8):e433. https://doi.org/10.1016/s1470-2045(17)30527-2 Erratum in: Lancet Oncol. 2018 Dec;19(12):e667.
10. Bartsch R, Berghoff AS, Furtner J, Marhold M, Bergen ES, Roider-Schur S, et al. Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial. Nat Med. 2022 Sep;28(9):1840–1847. https://doi.org/10.1038/s41591-022-01935-8
Review
For citations:
Afonin G.V., Glukhareva A.E., Kupriyanova E.I., Sofiychuk A.A., Belokhvostova А.S., Falaleeva N.A., Ivanov S.A., Kaprin A.D. Treatment of HER2/neu-positive breast cancer with brain metastases: a clinical case. Research and Practical Medicine Journal. 2026;13(2):131-139. (In Russ.) https://doi.org/10.17709/2410-1893-2026-13-2-10. EDN: TGZWDS
Views:
214
JATS XML
Email this article 