How would you approach systemic therapy for a postmenopausal female with metastatic ER+/HER2+ breast cancer (liver/bone) who achieved a CR for 5 years on trastuzumab/pertuzumab and exemestane, with continued asymptomatic brain progression?
Asymptomatic brain progression despite CNS surgery and SRS x2 over the past 2 years.
Answer from: Medical Oncologist at Community Practice
Switch to tucatanib, capecitabine, and trastuzumab. Consider returning to trastuzumab/pertuzumab based treatment at future systemic progression since currently there's no systemic progression.
Consider continuing exemestane. This could be based on recent NSABP trials showing no detriment to concomi...
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