Trastuzumab emtansine and stereotactic radiosurgery: An unexpected increase in clinically significant brain edema

Julie A. Carlson, Zohra Nooruddin, Chad Rusthoven, Anthony Elias, Virginia F. Borges, Jennifer R. Diamond, Brian Kavanagh, Peter Kabos

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Background In the last 10 years, multiple new targeted agents have been developed for patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Up to 55% of patients with HER2+ breast cancer will develop brain metastases requiring some form of radiation therapy. The interaction between radiation and these targeted agents is unknown and previously unreported. Methods In this series, we describe 4 patients who developed clinically significant brain edema at sites of treated brain metastases. These patients were treated with stereotactic radiosurgery and trastuzumab emtansine, the newest FDA-approved agent for metastatic HER2+ breast cancer. Additionally, we present rates of clinically significant radiation necrosis among all breast cancer patients treated during this same time period. Results Using previously published clinical and preclinical data, we then hypothesize possible mechanisms for this striking interaction. Conclusion Increased awareness of potential interactions between targeted agents and radiation to the brain is crucial.

Original languageEnglish (US)
Pages (from-to)1006-1009
Number of pages4
JournalNeuro-oncology
Volume16
Issue number7
DOIs
StatePublished - Jul 2014
Externally publishedYes

Keywords

  • brain metastases
  • HER2 positive breast cancer
  • stereotactic radiosurgery
  • targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Trastuzumab emtansine and stereotactic radiosurgery: An unexpected increase in clinically significant brain edema'. Together they form a unique fingerprint.

Cite this