{"entity":{"id":"tucatinib-triplet-brain-mets","kind":"pairing","name":"Tucatinib + trastuzumab + capecitabine for brain metastases","aka":[],"tldr":"The one regimen proven in a randomised trial to help HER2-positive brain metastases, extending survival in those patients by six months.","summary":"This combination gives tucatinib with trastuzumab and capecitabine to patients with HER2-positive breast cancer and brain metastases. Tucatinib is a small, HER2-selective molecule that crosses the blood-brain barrier, capecitabine adds a cytotoxic effect that is active in the central nervous system, and trastuzumab maintains systemic control. In the phase 3 HER2CLIMB trial, which included dedicated analyses of patients with brain metastases, the regimen improved intracranial progression-free survival and overall survival and produced responses in both untreated and previously treated brain lesions. It remains the one regimen shown in a randomised trial to help HER2-positive brain metastases, and it allows whole-brain radiation to be deferred in selected cases.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02614794: HER2CLIMB","url":"https://clinicaltrials.gov/study/NCT02614794"}],"tags":[],"related":[],"cancers":["breast-her2-positive"],"sections":[],"technologies":[],"targets":[],"drugs":["tucatinib","trastuzumab"],"companies":[],"institutions":[],"pathways":[],"terms":["her2-brain-metastases"],"trials":["her2climb"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"tucatinib","b":"trastuzumab","rationale":"Tucatinib is a small, HER2-selective molecule that crosses the blood-brain barrier; capecitabine adds CNS-active cytotoxic effect; trastuzumab maintains systemic control.","evidence":"Phase 3 (HER2CLIMB) with dedicated CNS analyses.","pairingType":"combination"},"route":"/pairings/tucatinib-triplet-brain-mets/","neighbours":{"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"her2-positive-breast-brain-metastases","kind":"cancer","name":"HER2-positive breast cancer with brain metastases","route":"/cancers/her2-positive-breast-brain-metastases/"}],"drug":[{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"},{"id":"tucatinib","kind":"drug","name":"Tucatinib","route":"/drugs/tucatinib/"}],"term":[{"id":"her2-brain-metastases","kind":"term","name":"HER2-positive brain metastases","route":"/terms/her2-brain-metastases/"}],"trial":[{"id":"her2climb","kind":"trial","name":"HER2CLIMB","route":"/trials/her2climb/"}]}}