Patients with leptomeningeal metastasis (LM) have historically had few treatment options. Now, researchers have found a combination of targeted therapies, tucatinib and trastuzumab, plus the chemotherapy drug, capecitabine, may improve symptoms and extend survival in some breast cancer patients with LM. The Phase II study included 17 female patients with newly diagnosed LM and HER2+ breast cancer.
Median overall survival (OS) in those treated with the combination therapy increased from a historical average of 4.4 months to 10 months. At the 18-month mark, 41% of patients were still alive. Under the combination treatment, disease progression also stalled, with a median of seven months before central nervous system progression, and seven of 12 evaluable patients also had improved neurologic deficits.