Breast cancer is the most common cancer in women, with around 2.3 million new cases globally each year, according to recent estimates. In India, over 200,000 cases are reported annually, making it a significant health concern. Breast cancer is also the second most common cause of brain metastases (BrM) in cancer patients. The incidence of brain metastases in breast cancer varies between 10% and 30% but can be much higher in certain subtypes.
Some breast cancer subtypes, like HER2-positive and triple-negative breast cancer, carry a higher risk of brain metastases. Around 25% to 50% of women with advanced HER2-positive breast cancer may develop brain metastases. This is often due to the limited ability of certain treatments to penetrate the brain, despite controlling cancer elsewhere in the body. For example, trastuzumab, a monoclonal antibody targeting HER2, has dramatically improved survival rates but is less effective at treating brain metastases due to its low penetration in the central nervous system (CNS).
Advances in Targeted Therapy for Brain Metastases:
- Lapatinib: Lapatinib, a tyrosine kinase inhibitor (TKI), has shown promising results for the treatment of HER2-positive breast cancer with brain metastases. This drug works by blocking both the HER2 and EGFR receptors and has the ability to cross the BBB, making it effective against brain metastases.
- Trastuzumab Deruxtecan: Trastuzumab deruxtecan, supplied under the brand Enhertu is an innovative drug recently approved for HER2-positive metastatic breast cancer. It is an antibody-drug conjugate (ADC) that targets HER2-positive cancer cells and delivers chemotherapy directly to them. The phase II DESTINY trial showed impressive results, making this drug a game-changer for patients whose cancer has spread to the brain.
- Tucatinib: Tucatinib, marketed under the brand name Tuksya, is a newer TKI that selectively inhibits HER2. It is notable for its effectiveness in treating brain metastases, especially when combined with trastuzumab and capecitabine. Tucatinib has been approved by the FDA and is available in India as well. Studies show that patients receiving this combination therapy experienced better control of brain metastases compared to previous treatment options.
Indian Data on Breast Cancer and Brain Metastases:
In India, breast cancer accounts for about 14% of all cancer cases, and the rise in cases is particularly noticeable in urban areas. Indian women tend to develop breast cancer at a younger age, with an average onset of 45-50 years, compared to 55-60 years in Western countries. The incidence of brain metastases in Indian breast cancer patients has been reported to be around 12-20%, reflecting global trends.
Due to limited access to advanced treatments in some parts of India, patients with brain metastases often face significant challenges. However, the introduction of drugs like trastuzumab deruxtecan and tucatinib in India brings hope for better management of this complex condition.
What are the signs of brain metastases in breast cancer?
Patients with brain metastases may experience headaches, memory problems, seizures, vision changes, or difficulty with coordination and balance.
How common are brain metastases in breast cancer patients?
The incidence ranges from 10% to 30%, depending on the subtype of breast cancer. HER2-positive and triple-negative breast cancer patients are at higher risk.
What treatment options are available for brain metastases in breast cancer?
Treatment options include surgery, radiation therapy, and targeted therapies like tucatinib, lapatinib, and trastuzumab deruxtecan.
Can brain metastases be prevented in breast cancer patients?
While there is no guaranteed way to prevent brain metastases, early detection and aggressive treatment of breast cancer can help reduce the risk.
Are the newer treatments for brain metastases available in India?
Yes, drugs like tucatinib and trastuzumab deruxtecan are now available in India and offer better outcomes for patients with HER2-positive breast cancer and brain metastases.
How/Where can I buy Tukysa, Enhertu, and Lapatinib online in India?
You can legally buy Tukysa, Enhertu, and Lapatinib online in India through the Indian Pharma Network (IPN), a trusted source for authentic, FDA-approved medications.
Conclusion:
Brain metastases continue to pose a serious threat to breast cancer patients, especially those with HER2-positive disease. However, ongoing advances in targeted therapies are improving outcomes and providing hope for patients dealing with both metastatic breast cancer and brain metastases. In India, the increasing availability of newer treatments like tucatinib and trastuzumab deruxtecan promises to change the landscape for breast cancer patients, offering them a better quality of life and extended survival.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6449077/
https://journals.lww.com/neur/fulltext/2019/67030/brain_metastasis__momentum_towards_understanding.32.aspx
