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Olubukola Ayodele: The conversation around brain metastases is never easy

Olubukola Ayodele/LinkedIn

Nov 17, 2024, 18:17

Olubukola Ayodele: The conversation around brain metastases is never easy

Olubukola Ayodele, Consultant Medical Oncologist at the University Hospitals of Leicester NHS Trust, posted on LinkedIn:

“It’s been a busy weekend: from the House of Commons on Friday to the UK Breast Cancer Group (UKBCG) annual conference on Saturday, where I had the honor of being part of a panel discussing intriguing and challenging cases submitted from across the country. Some of these cases involved brain metastases.

As an oncologist, the conversation around brain metastases is never easy due to its significant prognostic implications. Yet, this area represents an urgent and complex unmet need, particularly in HER2-positive breast cancer. Approximately 50% of HER2-positive metastatic breast cancer patients will develop brain metastases during their journey. The propensity of this cancer to spread to the brain is well established. While advances in systemic therapies have extended the lives of patients, this prolonged survival brings about an unfortunate increase in central nervous system (CNS) involvement. Current treatment options for brain metastases include stereotactic radiosurgery (SRS), whole brain radiotherapy (WBRT), and systemic therapies.

Pivotal studies such as HER2CLIMB, incorporating small molecules like tucatinib and capecitabine alongside trastuzumab, have demonstrated remarkable improvements in progression-free survival and overall survival. New-generation antibody-drug conjugates like Trastuzumab Deruxtecan (T-Dxd) are paving the way forward, showing promising results in penetrating the blood-brain barrier and targeting CNS lesions, as evident in clinical trials like DESTINY-BREAST 12 with objective response rates around 52%.

To address this pressing need, we must embrace a multidisciplinary approach by ensuring that patients with brain metastases are included in clinical trials, prioritizing CNS-specific research, and providing comprehensive support to tackle the physical, cognitive, and emotional challenges our patients face with brain metastases. Together, we can forge a brighter future for those affected by this disease.”

Dr. Olubukola Ayodele is a Consultant Medical Oncologist at the University Hospitals of Leicester NHS Trust, specializing in breast and genitourinary malignancies, including germ cell tumors. She is also an honorary Senior Lecturer at the University of Leicester and heads the Breast Cancer Clinical Trials Unit at the Leicester Cancer Research Centre. Dr. Ayodele’s work includes numerous publications, clinical trials, and collaborative research projects on molecular drivers and biomarkers in breast cancer. She is a member of ASCO, ESMO, ACP and UKBCG.