Recent research and FDA approvals continue to expand access to targeted therapies that can cross the blood–brain barrier and improve outcomes for patients with central nervous system (CNS) involvement. The following medications represent some of the most promising advancements across key breast cancer subtypes:
HER2-Positive Breast Cancer Treatments
- Tucatinib (Tukysa®) combined with Trastuzumab (Herceptin®) and Capecitabine (Xeloda®): Proven to improve outcomes and control CNS disease in HER2-positive patients with brain metastases. Approved for both metastatic and brain-metastatic HER2+ disease.
- Trastuzumab Deruxtecan (Enhertu®): An antibody-drug conjugate showing significant CNS activity and extended progression-free survival in ongoing DESTINY-Breast trials. Now approved for metastatic HER2-positive and HER2-low breast cancer.
Triple-Negative Breast Cancer (TNBC) Treatments
- Sacituzumab Govitecan (Trodelvy®): FDA-approved antibody-drug conjugate that improves overall survival in metastatic TNBC, including patients with stable or treated brain metastases.
- Pembrolizumab (Keytruda®) and other PD-1/PD-L1 inhibitors: Used in combination with chemotherapy for high-risk early-stage and metastatic TNBC; ongoing trials show emerging benefit for CNS involvement.
- (Emerging Research) Datopotamab Deruxtecan (Dato-DXd): A next-generation antibody-drug conjugate in clinical trials showing encouraging results for patients with CNS progression.
HR-Positive / HER2-Negative Breast Cancer Treatments
- Abemaciclib (Verzenio®): A CDK4/6 inhibitor approved for early-stage high-risk and metastatic HR+ disease; ongoing studies indicate potential benefit for patients with brain metastases.
- Alpelisib (Piqray®) and other PI3K inhibitors: Used for PIK3CA-mutated HR+ breast cancer; new PI3K inhibitors under investigation may offer future benefit for CNS involvement.
- (Investigational) Elacestrant (Orserdu®): An oral selective estrogen receptor degrader (SERD) approved for ESR1-mutated HR+ metastatic disease, with early studies exploring CNS activity.
A Rapidly Evolving Field
Breakthroughs in breast cancer research are advancing faster than ever — especially in the fight against brain metastases. Talk with your oncologist about clinical trials and newly approved therapies that may be right for your breast cancer subtype.
At Carrie Lyn Cares, we remain committed to ensuring that awareness, access, and education keep pace with every scientific advancement — so every woman can fight with knowledge, not fear.
Sources & References
(Updated October 2025)
- FDA Center for Drug Evaluation and Research. Enhertu (fam-trastuzumab deruxtecan-nxki) label, 2025.
- Murthy RK et al. New England Journal of Medicine. 2020;382:597–609. HER2CLIMB Trial (Tucatinib + Trastuzumab + Capecitabine).
- Modi S et al. Lancet Oncology. 2024;25(2):135–148. DESTINY-Breast12 Trial (Trastuzumab Deruxtecan in CNS Metastases).
- Bardia A et al. Journal of Clinical Oncology. 2021;39(10):1082–1094. TROPiCS-02 Trial (Trodelvy in TNBC).
- Lin NU et al. Clinical Cancer Research. 2023;29(3):526–537. Abemaciclib CNS Activity Data.
- Rugo HS et al. Nature Reviews Clinical Oncology. 2024. Emerging Systemic Therapies for Breast Cancer Brain Metastases.
