This article is very much about the central nervous system as the first site of mets for HER2.
Incidence of central nervous system metastases in patients with HER2-positive metastatic breast cancer treated with pertuzumab, trastuzumab, and docetaxel: results from the randomized phase III study CLEOPATRA (2014)
http://m.annonc.oxfordjournals.org/c...25/6/1116.full
"Results from CLEOPATRA have demonstrated that the combination of pertuzumab with trastuzumab and docetaxel further improves systemic disease control by trastuzumab plus docetaxel, resulting in a significant and clinically meaningful prolongation of median progression-free [median time 15 months vs 11.9 months placebo group] and overall survival [median time34.4 months vs 26.3 months with placebo]. Our results presented here suggest that this improvement in systemic disease control with pertuzumab-based treatment delays the onset of CNS disease. Advances in systemic disease control and overall survival may result in an increase in the number of patients who will eventually develop CNS metastases; therefore, better treatment options for CNS disease are needed to increase quality of life and prolong survival of these patients. Based on results from CLEOPATRA, further investigation into the activity of HER2-targeted antibodies in patients with CNS disease from HER2-positive breast cancer is warranted"