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Purpose
To assess the use of trastuzumab concurrently with whole brain ra
diotherapy (WBRT) for patients with brain metastases from human epi
dermal growth factor receptor-2¨Cpositive breast cancer.
Methods and Materials
Between April 2001 and April 2007, 31 patients with brain metastases from human epidermal growth factor receptor-2¨Cpositive breast cancer were referred for WBRT with concurrent trastuzumab. At brain progression, the median age was 55 years (range, 38?3), and all patients had a performance status of 0?. The patients received trastuzumab 2 mg/kg weekly (n = 17) or 6 mg/kg repeated every 21 days (n = 14). In 26 patients, concurrent WBRT delivered 30 Gy in 10 daily fractions. In 6 patients, other fractionations were chosen because of either poor performance status or patient convenience.
Results
After WBRT, radiologic responses were observed in 23 patients (74.2 % ), including 6 (19.4 % ) with a complete radiologic response and 17 (54.8 % ) with a partial radiologic response. Clinical responses were observed in 27 patients (87.1 % ). The median survival time from the start of WBRT was 18 months (range, 2?5). The median interval to brain progression was 10.5 months (range, 2?7). No Grade 2 or greater acute toxicity was observed.
Conclusion
The low toxicity of trastuzumab concurrently with WBRT should probably not justify delays. Although promising, these preliminary data warrant additional validation of trastuzumab as a potential radiosensitizer for WBRT in brain metastases from breast cancer in the setting of a clinical trial.
