Spector Neil
Duke Comprehensive Cancer Center, Durham, NC 27705, USA.
Clin Breast Cancer. 2008 Mar;8 Suppl 3:S94-9. doi: 10.3816/cbc.2008.s.005.
Although trastuzumab-based therapy has changed the treatment paradigm for ErbB2-positive breast cancers, most patients eventually develop progressive disease. Of particular interest is the issue of disease progression in the central nervous system, a safe haven from high molecular weight antibodies like trastuzumab, which have limited ability to cross the blood-brain barrier. This review will discuss therapeutic options for when disease progression has occurred on trastuzumab-based therapies, including central nervous system progression, continuation of trastuzumab-based therapy, addition of novel targeted therapies, and the use of small-molecule tyrosine kinase inhibitors targeting ErbB receptors.
尽管基于曲妥珠单抗的疗法改变了ErbB2阳性乳腺癌的治疗模式，但大多数患者最终仍会出现疾病进展。特别值得关注的是中枢神经系统的疾病进展问题，中枢神经系统是像曲妥珠单抗这样的高分子量抗体难以企及的“安全港”，因为这类抗体穿越血脑屏障的能力有限。本综述将讨论基于曲妥珠单抗的疗法出现疾病进展时的治疗选择，包括中枢神经系统进展、继续基于曲妥珠单抗的治疗、添加新型靶向疗法以及使用靶向ErbB受体的小分子酪氨酸激酶抑制剂。
