UO Oncologia, Azienda Ospedaliera Treviglio, Piazzale Ospedale 1, 24047, Treviglio, Bergamo, Italy,
Target Oncol. 2013 Dec;8(4):291-4. doi: 10.1007/s11523-012-0240-y. Epub 2012 Nov 30.
Malignant ascites is quite rare in breast cancer and is mainly associated with a lobular histology. To date, no studies have evaluated locoregional therapy for malignant ascites in breast cancer. The anti-epithelial cell adhesion molecule (EpCAM), trifunctional antibody catumaxomab was approved in the European Union for the intraperitoneal (i.p.) treatment of malignant ascites in patients with EpCAM-positive carcinomas where standard therapy is not available or no longer feasible. We report the case of a 69-year-old female with pretreated breast cancer who received i.p. catumaxomab for the treatment of malignant ascites and showed a regression of liver metastases. The patient originally underwent a left mastectomy and ipsilateral axillary lymph node dissection for an invasive ductal carcinoma in 1995. Following several lines of treatment, she was enrolled in February 2010 in a phase IIIb study (CASIMAS) investigating the safety of a 3-h i.p. catumaxomab infusion. In addition to a local benefit, as shown by an improvement in malignant ascites and a prolongation of the paracentesis-free interval with i.p. catumaxomab, a computed tomography scan, performed some weeks after catumaxomab administration, showed a regression of liver metastases. In addition to a locoregional effect on EpCAM-positive disease, i.p. catumaxomab may also show systemic effects. The use of i.p. catumaxomab for the treatment of malignant ascites due to breast cancer should be explored further in appropriate clinical studies and its possible systemic effects should also be further investigated.
恶性腹水在乳腺癌中较为罕见，主要与小叶状组织学相关。迄今为止，尚无研究评估过乳腺癌恶性腹水的局部区域治疗。抗上皮细胞黏附分子（EpCAM）三功能抗体 catumaxomab 已在欧盟获批，可用于治疗 EpCAM 阳性癌种的恶性腹水，这些患者的标准治疗无效或不再适用。我们报告了一例 69 岁女性患者，其乳腺癌经预处理后接受了腹腔内（i.p.） catumaxomab 治疗恶性腹水，并显示肝脏转移瘤消退。该患者最初于 1995 年因浸润性导管癌行左侧乳房切除术和同侧腋窝淋巴结清扫术。经过几线治疗后，她于 2010 年 2 月入组了一项研究 catumaxomab 安全性的 IIIb 期研究（CASIMAS）。除了局部获益，如 i.p. catumaxomab 改善恶性腹水并延长了无需再次引流的间隔时间外，在 catumaxomab 给药后数周进行的计算机断层扫描显示肝脏转移瘤消退。除了对 EpCAM 阳性疾病的局部作用外，i.p. catumaxomab 还可能具有全身作用。应进一步在适当的临床研究中探索 i.p. catumaxomab 治疗乳腺癌所致恶性腹水的应用，并进一步研究其可能的全身作用。
