Re: How Her2+ BC patients develop brain metastases
Nina had several lesions on her brain. When we did "whack-a-mole" radiation, we never were able to eliminate the lesions. When se did the IT Herceptin and Topotecan, we put all but one into remission. That one we had to have treated with a laser. The cancer tumors can modify with treatment. Immunotherapy might work for five years and then need something else. The Herceptin and Toptoecan pairing delays remission and gets most of the lesions. The more we have patients treated, the more we know about slightly modifying treatment for each case. The IT Herceptin and Topotecan should get rid of most, if not all, of the brain lesions. Then CyberKnife or another means can deal with any remaining disease. Six years ago, the median time after discovery was 4 to 6 months. With IT Herceptin and Topotecan, it is at about 30 to 36 months, but at over four years (as the database gets more time after treatment) for those who are not paralyzed.
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