BCAC’s Libby Burgess was pleased to meet up with advanced breast cancer expert Fatima Cardoso at the ESMO Asia Pacific Congress in Singapore this December.
Dr Cardoso discussed strategies to treat brain metastases in advanced HER2+ breast cancer. The HER2-Climb trial showed the combination of tucatinib, capecitabine and trastuzumab is effective, giving overall survival benefits. In New Zealand, Pharmac has so far declined to fund trastuzumab in this setting and tucatinib is registered but also unfunded, while the chemotherapy drug capecitabine is funded and has some effectiveness when used alone. There is also evidence for the effectiveness of T-DXd and Kadcyla (T-DM1) for brain metastases. These are larger molecules originally thought to be unable to cross the blood brain barrier, but they do have efficacy and especially after radiotherapy they can cross the barrier to target these tumours.
