Chang Alex Y, Ying Xu Xiao
Department of Medical Oncology, Johns Hopkins Singapore International Medical Centre, Johns Hopkins University, Singapore. ; Research Department, Johns Hopkins Singapore Pte Ltd, Singapore.
Research Department, Johns Hopkins Singapore Pte Ltd, Singapore.
Breast Cancer (Auckl). 2015 May 24;9:19-24. doi: 10.4137/BCBCR.S21176. eCollection 2015.
Brain metastases are common in patients with advanced breast cancer (BC), causing considerable morbidity and mortality. Eribulin is a microtubule dynamics inhibitor approved for treating certain patients with metastatic BC, previously treated with an anthracycline and a taxane. In the 301 phase 3 study in 1102 women with advanced BC, eribulin and capecitabine treatments did not differ for co-primary endpoints (overall survival [OS]: 15.9 vs 14.5 months, P = 0.056; progression-free survival [PFS]: 4.1 vs 4.2 months, P = 0.30). Here, we report outcomes for six patients (eribulin, n = 3; capecitabine, n = 3) who had received treatment for brain metastases from BC (BCBM) at baseline. All eribulin-treated patients experienced brain lesion shrinkage at some point during treatment, compared with one capecitabine-treated patient. Fewer patients in study 301 developed new BCBM with eribulin (13/544, 2.4%) compared with capecitabine (25/546, 4.6%). Eribulin does not cross the healthy blood-brain barrier (BBB), but could have the potential to do so after cranial radiation therapy. Capecitabine may cross the BBB and has demonstrated activity in BCBM. Data from these patients and previous cases suggest that further investigation of eribulin for BCBM may be warranted.
脑转移在晚期乳腺癌（BC）患者中很常见，会导致相当高的发病率和死亡率。艾日布林是一种微管动力学抑制剂，被批准用于治疗某些转移性BC患者，这些患者之前接受过蒽环类药物和紫杉烷治疗。在一项针对1102名晚期BC女性的301期3期研究中，艾日布林和卡培他滨治疗的共同主要终点无差异（总生存期[OS]：15.9个月对14.5个月，P = 0.056；无进展生存期[PFS]：4.1个月对4.2个月，P = 0.30）。在此，我们报告了6例患者（艾日布林组，n = 3；卡培他滨组，n = 3）的结果，这些患者在基线时已接受过BC脑转移（BCBM）的治疗。与1例接受卡培他滨治疗的患者相比，所有接受艾日布林治疗的患者在治疗期间的某个时间点都出现了脑病变缩小。与卡培他滨（25/546，4.6%）相比，301研究中接受艾日布林治疗的患者发生新的BCBM的比例更低（13/544，2.4%）。艾日布林不能穿过健康的血脑屏障（BBB），但在颅脑放射治疗后可能有穿过的潜力。卡培他滨可能穿过BBB，并已在BCBM中显示出活性。这些患者的数据和之前的病例表明，可能有必要对艾日布林用于BCBM进行进一步研究。
