Linot B, Campone M, Augereau P, Delva R, Abadie-Lacourtoisie S, Nebout-Mesgouez N, Capitain O
Medical Oncology Department, Institut de Cancérologie de l'Ouest Paul Papin, 2 Rue Moll, 49933, Angers Cedex 9, France,
J Neurooncol. 2014 Apr;117(2):253-9. doi: 10.1007/s11060-014-1378-5. Epub 2014 Jan 31.
Brain metastases (BM) can affect up to 45 % of a high-risk breast cancer (BC) population. Liposomal doxorubicin (LD)-based chemotherapy has demonstrated efficacy in the treatment of BC and LD crosses the blood-brain barrier. The aim of this retrospective study is to evaluate the efficacy of the LD-cyclophosphamide (CTX) combination in BM related to BC. Patients diagnosed with BM related to BC and treated with the LD-CTX combination were eligible. BM objective response rate (BM-ORR), BM disease control rate (BM-DCR), BM progression-free survival, overall survival (OS) and safety were analyzed. 29 patients were eligible. The median time from metastatic diagnosis to brain involvement was 12 months. BM was more frequently observed in HER2+ patients. On average, three courses of chemotherapy were administered without grade 3-4 limiting adverse events. After three cycles, BM-ORR and BM-DCR were 41.4 and 58.6 % respectively versus 50 and 62.5 % when no prior radiotherapy was administered. From BM diagnosis, OS was 23 months. A high BM-ORR is observed with the LD-CTX combination in patients with BM related to BC. This is an attractive therapeutic option for these patients, especially when no prior whole brain radiotherapy has been administered.
脑转移(BM)可影响高达45%的高危乳腺癌(BC)人群。基于脂质体阿霉素(LD)的化疗已证明在治疗乳腺癌方面有效,且LD可穿过血脑屏障。这项回顾性研究的目的是评估LD-环磷酰胺(CTX)联合用药对与乳腺癌相关的脑转移的疗效。诊断为与乳腺癌相关的脑转移并接受LD-CTX联合治疗的患者符合条件。分析脑转移客观缓解率(BM-ORR)、脑转移疾病控制率(BM-DCR)、脑转移无进展生存期、总生存期(OS)和安全性。29例患者符合条件。从转移诊断到脑受累的中位时间为12个月。HER2+患者中更常观察到脑转移。平均给予三个疗程的化疗,无3-4级限制性不良事件。三个周期后,BM-ORR和BM-DCR分别为41.4%和58.6%,而未进行过放疗时分别为50%和62.5%。从脑转移诊断起,总生存期为23个月。在与乳腺癌相关的脑转移患者中,LD-CTX联合用药观察到较高的BM-ORR。对于这些患者,这是一个有吸引力的治疗选择,尤其是在未进行过全脑放疗的情况下。