Intrathecal (IT) Herceptin (Trastuzumab) for brain mets (Leptomeningeal Metastases)

[schoonder]

Would neo-adjuvant t-dm1 after surgery reduce possibility of brain mets if treatment was effective in eradicating remnants of disease that are currently undetectable?

Would intrathecal t-dm1 make for an effective tool in treating her2+ brain mets?

[Rolepaul]

No one to my knowledge has ever done TDM-1 via intrathecal administration means. If there is no brain or spine mets detected within seven years after mastectomy, there is a high level of faith that there will not be found later. The problem is that these is no absolute way to make sure that there is not any involvement in the brain and spine prior to that. If there is no lymph node involvement, that would indicate that there is also a low likelihood of brain or spine involvement. The difference between now and the past is that it is clear that the previous methatrexate and other "harsh" chemical treatments caused side effects that were unacceptable, with IT Herceptin now being tested by several individuals for side effects (and finding none).