Seems like Tykerb would be the one (or w/H) to lean on considering brain mets, no?
Any access to agents that could resensitize to her2 and endocrine therapy?
i.e. this kind of thinking but up to date:
www.jbc.org/cgi/reprint/272/3/1682.pdf
Dunno if this is relevant to Ed, but maybe the drugs involved are:
1: J Neurosurg. 2009 Feb 6. [Epub ahead of print]
Links
Brain magnetic resonance imaging changes after sorafenib and sunitinib chemotherapy in patients with advanced renal cell and breast carcinoma.
Hill KL,
Lipson AC,
Sheehan JM.
Penn State Milton S. Hershey Medical Center, Department of Neurosurgery, Hershey, Pennsylvania.
Object The authors report novel imaging findings associated with the treatment of sorafenib (Nexavar) and sunitinib (Sutant), 2 agents used in the treatment of advanced metastatic disease. Methods Patients with renal cell and breast carcinoma metastases to the brain were identified from the prospective database at the Penn State Hershey Medical Center and Penn State Cancer Institute. Results Four patients who received sorafenib or sunitinib after surgical or radiosurgical treatment of their metastases were identified from the database. Clinical and/or radiographic changes consisting of seizures and cognitive or motor changes were described, associated with an increase in peritumoral edema and enhancement. These findings were observed to improve with discontinuation of the medications. Conclusions The administration of sorafenib and sunitinib in patients with metastatic breast and renal cell carcinoma may lead to reversible clinical and imaging changes following surgical or radiosurgical treatment of their brain lesions. The authors hypothesize that leakage of the drug across a locally impaired blood-brain barrier contributes to peritumoral edema and inflammation, which may be erroneously interpreted as disease progression.
PMID: 19199506 [PubMed - as supplied by publisher]