Teplinsky Eleonora, Esteva Francisco J
Hofstra-North Shore LIJ School of Medicine, Monter Cancer Center, 450 Lakeville Road, Lake Success, NY, 11042, USA.
Curr Oncol Rep. 2015 Oct;17(10):46. doi: 10.1007/s11912-015-0471-z.
Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer are at an increased risk of developing brain metastases. The incidence and prevalence of central nervous system (CNS) disease are increasing due to improved survival, which can be attributed to better systemic therapies for extracranial disease. The current standard of care for brain metastases includes a combination of surgery and/or radiation. Systemic therapies are typically reserved for patients with intracranial progression following radiation, due to their limited ability to cross the blood-brain barrier. None of the available anti-HER2 agents (trastuzumab, lapatinib, pertuzumab, and ado-trastuzumab emtansine (T-DM1)) are currently approved for the treatment of brain metastases. Research is underway evaluating novel anti-HER2 agents, which have demonstrated CNS activity. This article discusses the current data on using anti-HER2 therapies to treat CNS disease as well as the newer anti-HER2 agents, which may overcome the current challenges faced in treating brain metastases in the HER2-positive patient population.
人表皮生长因子受体2（HER2）阳性乳腺癌患者发生脑转移的风险增加。由于生存改善，中枢神经系统（CNS）疾病的发病率和患病率正在上升，这可归因于颅外疾病更好的全身治疗。目前脑转移的标准治疗包括手术和/或放疗的联合应用。由于全身治疗穿过血脑屏障的能力有限，通常仅用于放疗后颅内进展的患者。目前可用的抗HER2药物（曲妥珠单抗、拉帕替尼、帕妥珠单抗和ado曲妥珠单抗（T-DM1））均未获批用于治疗脑转移。正在进行评估新型抗HER2药物的研究，这些药物已显示出中枢神经系统活性。本文讨论了使用抗HER2疗法治疗中枢神经系统疾病的当前数据以及可能克服HER2阳性患者群体治疗脑转移当前面临挑战的新型抗HER2药物。
