Department of Medical Oncology, Azienda USL, Via Altura 3 40139, Bologna, Italy.
Future Oncol. 2013 Nov;9(11):1653-64. doi: 10.2217/fon.13.90.
Breast cancer is the second most common source of brain metastases (BM). The incidence of BM in breast cancer patients has increased over the past decade, especially among patients with HER-2-positive breast cancer. This is probably due to how aggressive the HER-2-positive disease is but also to the prolongation of survival obtained with current treatments, which allow good control of extracranial disease but are unable to cross the blood-brain barrier. At present, whole-brain radiotherapy, surgery and radiosurgery/stereotactic radiotherapy represent the cornerstone of treatment for BM, while the role of pharmacological therapy remains uncertain. Lapatinib demonstrated activity against BM from HER-2-positive breast cancer in small Phase II and retrospective studies, mainly in combination with capecitabine, and cases of dramatic responses to such treatment are present in literature. In this review we focus on the available clinical data regarding the treatment of BM from HER-2-positive breast cancer and on new concepts about the treatment and evaluation of the CNS response.
乳腺癌是脑转移（BM）的第二大常见来源。在过去十年中，乳腺癌患者发生 BM 的比例有所增加，尤其是 HER-2 阳性乳腺癌患者。这可能是由于 HER-2 阳性疾病的侵袭性，也可能是由于目前治疗方法的生存延长，这些治疗方法可以很好地控制颅外疾病，但无法穿过血脑屏障。目前，全脑放疗、手术和放射外科/立体定向放疗是 BM 治疗的基石，而药物治疗的作用仍不确定。拉帕替尼在小规模的 II 期和回顾性研究中显示出对 HER-2 阳性乳腺癌 BM 的活性，主要与卡培他滨联合使用，并且文献中存在对这种治疗方法产生显著反应的病例。在这篇综述中，我们重点介绍了关于 HER-2 阳性乳腺癌 BM 治疗的现有临床数据，以及关于 CNS 反应的治疗和评估的新概念。
