authors include Burstein, Harris, Winer
An obvious question is this: should screening
be considered in asymptomatic patients? For example,
women treated with trastuzumab have a 30 – 40% risk
of developing CNS disease. Should they be screened?
To our knowledge, there currently are no data to in-
dicate that the earlier detection of CNS metastases will
have any effect on overall survival. Nevertheless, neu-
rologic impairment from symptomatic brain metasta-
ses, even if it is transient, can be devastating. If the
high incidence of CNS disease reported herein is con-
firmed by other investigators, it may be worthwhile to
reevaluate screening procedures. Ultimately, it will be
critical to develop new agents that are able to pene-
trate the blood-brain barrier or we will continue to
encounter similar problems with the development of
new and more effective therapies.
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