Department of Clinical Oncology, Cairo University Hospital, Cairo, Egypt.
Future Oncol. 2012 Feb;8(2):135-44. doi: 10.2217/fon.11.149.
In recent years, brain metastases have emerged as a main challenge affecting the morbidity and mortality of patients with HER2-positive metastatic breast cancer. In the era following trastuzumab, approximately 30% of these patients develop brain metastases. Trastuzumab does not cross the blood-brain barrier, hence its role is limited to controlling extra-CNS metastases. Lapatinib emerged as a potential candidate; however, its use as a single agent was associated with modest responses. Combination with capecitabine was associated with good results, particularly in patients with newly diagnosed brain metastases. In this article, we discuss the role of trastuzumab and lapatinib in patients with HER2-positive breast cancer with brain metastases. We also highlight the complex structure of the blood-brain barrier and elucidate different potential strategies that could be useful in improving drug delivery.
近年来，脑转移已成为影响 HER2 阳性转移性乳腺癌患者发病率和死亡率的主要挑战。在曲妥珠单抗之后的时代，大约 30%的此类患者出现脑转移。曲妥珠单抗不能穿过血脑屏障，因此其作用仅限于控制中枢神经系统外的转移。拉帕替尼作为一种潜在的候选药物出现；然而，作为单一药物使用，其疗效有限。与卡培他滨联合使用可获得较好的结果，特别是对新诊断为脑转移的患者。本文讨论了曲妥珠单抗和拉帕替尼在 HER2 阳性乳腺癌伴脑转移患者中的作用。我们还强调了血脑屏障的复杂结构，并阐明了不同的潜在策略，这些策略可能有助于改善药物递送。
