Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer.
Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer.
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DOI：
10.1038/sj.bjc.6601970
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发表时间：
2004-08-16
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
作者：
曲妥珠单抗是治疗HER-2过表达的转移性乳腺癌（MBC）患者的有效药物。在接受曲妥珠单抗治疗的患者中观察到脑转移瘤（BM）的发生率较高。对1999年7月至2002年12月在克里斯蒂医院开始曲妥珠单抗治疗转移性乳腺癌的100例患者进行了回顾性图表审查。排除7例患者; 5名患者在开始曲妥珠单抗治疗前发生中枢神经系统转移，2名患者的数据不足。在其余93例患者中，迄今为止有23例（25%）发生BM。总共有46名患者死亡，其中18名（39%）在死亡前被诊断为BM。在23例发生BM的患者中，18例（78%）为激素受体阴性，18例（78%）有内脏疾病。单因素分析显示，脑疾病的发展与激素受体状态和内脏疾病的存在之间存在显着关联。总之，接受曲妥珠单抗治疗的MBC患者中有很高比例发生症状性脑转移。HER-2阳性乳腺癌可能有脑的偏好，或者曲妥珠单抗治疗可能通过延长生存期来改变疾病模式。解决这一问题的新策略需要在这组患者中进行调查。
Trastuzumab is an effective treatment for patients with metastatic breast cancer (MBC) that overexpresses HER-2. A high incidence of brain metastases (BM) has been noted in patients receiving trastuzumab. A retrospective chart review was conducted of 100 patients commencing trastuzumab for metastatic breast cancer from July 1999 to December 2002, at the Christie Hospital. Seven patients were excluded; five patients developed central nervous system metastases prior to starting trastuzumab, and inadequate data were available for two. Out of the remaining 93 patients, 23 (25%) have developed BM to date. In all, 46 patients have died, and of these 18 (39%) have been diagnosed with BM prior to death. Of the 23 patients developing BM, 18 (78%) were hormone receptor negative and 18 (78%) had visceral disease. Univariate analysis showed a significant association between the development of cerebral disease and both hormone receptor status and the presence of visceral disease. In conclusion, a high proportion of patients with MBC treated with trastuzumab develop symptomatic cerebral metastases. HER-2-positive breast cancer may have a predilection for the brain, or trastuzumab therapy may change the disease pattern by prolonging survival. New strategies to address this problem require investigation in this group of patients.
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