How, if at all, does your systemic therapy management differ between HER2+ breast cancer patients with active CNS metastases compared to those with stable/treated CNS metastases?  

For HER2+ breast cancer patients with active CNS metastases, the focus is on using systemic therapies with proven CNS penetration, such as tucatinib combined with trastuzumab and capecitabine or T-DXd, to address both systemic and CNS disease. In contrast, for those with stable or treated CNS metast...

As a breast cancer specialist with a focus on CNS disease, I use Enhertu in my large population of leptomeningeal disease patients in both Her2 positive; Her2, Her2 ultralow, and Her2 gain-of-function mutation patients daily. It’s the most effective drug for the control of leptomeningeal disea...

I am more likely to utilize the HER2CLIMB regimen (capecitabine + tucatinib + trastuzumab) in an earlier line of therapy for patients with CNS metastases in general. Currently, my systemic therapy choice does not vary significantly by whether CNS mets are active or stable/treated. However, the DESTI...

We always take into consideration the sites where disease is active. We always try to have patients with CNS metastases on treatment with agents demonstrated to be active in CNS. However, in patients with active CNS metastases, I may change the line of therapy to make sure an active CNS agent is in ...