ArticleBreast cancer (Dove Medical Press)2026
Management of HER2+ Breast Cancer with and without Brain Metastases in Saudi Arabia: Literature Insights and an Expert Survey of Current Practices.
Article in Breast cancer (Dove Medical Press), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
Purpose: New therapies can improve outcomes in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (mBC), including those with brain metastases (BMs). To our knowledge this is the first review focusing on HER2+ mBC, with and without BMs, in the Saudi Arabian context. This review evaluated the epidemiology of HER2+ mBC with and without BMs, treatment and monitoring practices in Saudi Arabia. Methods: Two key strategies have been pursued: a comprehensive literature review of international recommendations to complement a focused, nationally-representative cross-sectional survey involving BC experts in Saudi Arabia using an 18-item questionnaire. Results: Twelve expert BC physicians from tertiary treatment centers in Saudi Arabia completed the survey. It was estimated that 15-35% of mBC patients present with HER2+ disease, with 5-25% developing BMs. Internationally, brain imaging of asymptomatic patients is currently a subject of controversial debate; only 17% of surveyed physicians conducted brain imaging in asymptomatic patients. Treatment of HER2+ mBC with and without BMs in Saudi Arabia largely aligned with international recommendations identified in our literature analysis, although access to lapatinib, tucatinib and neratinib can be limited and may lead to use of alternative regimens. In third-line or later settings, tucatinib combinations were favored by physicians. Conclusion: The management of HER2+ mBC with and without BMs among expert physicians in Saudi Arabia is aligned with international guidelines. The tucatinib-combination may be considered the standard of care for adult patients with HER2+ locally advanced or mBC who have received at least two prior anti-HER2+ treatment regimens, including patients with BMs. Ensuring access to innovative HER2+ mBC therapies across Saudi Arabia is crucial to supporting best practice.
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