SynthesisStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2025
Effects of concurrent HER2-directed therapy on development of cerebral radionecrosis after stereotactic radiotherapy: a systematic review.
Synthesis in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Radiation therapy combined with tyrosine kinase inhibitors in 826 patients with HER2-positive breast cancer brain metastases: a systematic review and network meta-analysis.Neurosurgical review · 2026Pooled it
- Dose selection and clinical decision-making after Gamma Knife surgery for large brain metastases: implications for early identification of true progression.Journal of neuro-oncology · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWith increasing use of human epithelial growth factor receptor two (HER2)-targeted therapies, outcomes for numerous breast cancer patients have improved. Nevertheless, patients with HER2-positive tumours face a comparatively heightened risk for developing brain metastases (BM), which are often treated with stereotactic radiosurgery (SRS). Radionecrosis represents one of the clinically most significant adverse events of SRS. However, a knowledge gap remains regarding the effects of concurrent use of HER2-targeted therapies with SRS on development of radionecrosis, given conflicting findings in existing studies.
methodsThis systematic review was conducted in May 2024 through a search across electronic databases PubMed/MEDLINE and Cochrane library and was supplemented by citation searching and an artificial intelligence (AI) search.
resultsThe literature search yielded 194 articles. After applying eligibility criteria, a total of 13 studies with 3219 patients total were included, with approximately 270 patients in the topic-relevant subgroup. Investigated substances vary in different publications and include HER2 antibodies, antibody-drug conjugates (ADCs), such as trastuzumab emtansine (T-DM1), and kinase inhibitors. Four of six studies on ADCs demonstrated a higher risk for radionecrosis with concurrent administration. Two studies on lapatinib found no significant effects, as did as most studies investigating mainly HER2 antibodies. One publication reported an even lower risk for radionecrosis (RN) with concurrent use of HER2/EGFR tyrosine kinase inhibitors (TKIs).
conclusionWhile concurrent use of T‑DM1/ADCs seems associated to elevated radionecrosis risk, an ambiguous situation for other substances persists. Heterogenous study designs with varying substances, definitions of concurrent use, and radionecrosis parameters must be considered. Included studies are partly limited by sample size and retrospective study design. Therefore, clinical implications remain difficult to claim; further research on this topic is needed.
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