Nieder Carsten, Aandahl Gro, Dalhaug Astrid
Department of Oncology and Palliative Medicine, Nordland Hospital, P.O. Box 1480, 8092 Bodø, Norway.
Case Rep Oncol Med. 2012;2012:537183. doi: 10.1155/2012/537183. Epub 2012 Aug 16.
Patients with triple receptor-negative breast cancer often develop aggressive metastatic disease, which also might involve the brain. In many cases, systemic and local treatment is needed. It is important to consider the toxicity of chemo- and radiotherapy, especially when newly approved drugs become available. Randomised studies leading to drug approval often exclude patients with newly diagnosed brain metastases. Here we report our initial experience with eribulin mesylate and whole-brain radiotherapy (WBRT) in a heavily pretreated patient with multiple brain, lung, and bone metastases from triple receptor-negative breast cancer. Eribulin mesylate was given after 4 previous lines for metastatic disease. Two weeks after the initial dose, that is, during the first cycle, the patient was diagnosed with 5 brain metastases with a maximum size of approximately 4.5 cm. She continued chemotherapy and received concomitant WBRT with 10 fractions of 3 Gy. After 3 cycles of eribulin mesylate, treatment was discontinued because of newly diagnosed liver metastases and progression in the lungs. No unexpected acute toxicity was observed. The only relevant adverse reactions were haematological events after the third cycle (haemoglobin 9.5 g/dL, leukocytes 3.1 × 10(9)/L). The patient died from respiratory failure 18.5 months from diagnosis of metastatic disease, and 2.7 months from diagnosis of brain metastases. To the best of our knowledge, this is the first report on combined WBRT and eribulin mesylate.
三受体阴性乳腺癌患者常发生侵袭性转移性疾病，脑转移也较为常见。多数情况下，需要进行全身和局部治疗。考虑化疗和放疗的毒性非常重要，尤其是在有新批准药物可用时。导致药物获批的随机研究通常会排除新诊断为脑转移的患者。在此，我们报告了在一名三受体阴性乳腺癌伴多发脑、肺和骨转移且经过多次治疗的患者中，使用甲磺酸艾瑞布林和全脑放疗（WBRT）的初步经验。该患者在接受过4线转移性疾病治疗后开始使用甲磺酸艾瑞布林。初始剂量给药两周后，即在第一个周期期间，患者被诊断出有5个脑转移瘤，最大直径约4.5厘米。她继续化疗并同时接受了10次、每次3Gy的WBRT。在接受3个周期的甲磺酸艾瑞布林治疗后，因新诊断出肝转移和肺部病情进展而停止治疗。未观察到意外的急性毒性反应。唯一相关的不良反应是第三个周期后的血液学事件（血红蛋白9.5g/dL，白细胞3.1×10⁹/L）。该患者在诊断为转移性疾病18.5个月后，诊断为脑转移2.7个月后死于呼吸衰竭。据我们所知，这是关于WBRT联合甲磺酸艾瑞布林的首例报告。
