Wang Qing, Zhang Fenghua, Gao Hongyan, Xu Yun
Department of Gynecology, Changzhou First People's Hospital, Changzhou, China.
Department of Gynecology, Changzhou First People's Hospital, Changzhou, China. Email:
Ann Palliat Med. 2021 Jan;10(1):818-827. doi: 10.21037/apm-21-113.
Endometrial cancer (EC) is the second most common gynecologic malignancy in China, and the incidence and mortality rates have increased in recent years. Brain metastasis from EC is extremely rare, affecting only 0.3-1.16% of EC patients. The prognosis for patients with brain metastasis from EC is poor, with a median survival time of 3.5-6.5 months from the diagnosis of brain metastasis. Niraparib is a poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor that uses the concept of synthetic lethality in the presence of a mutation in the breast cancer susceptibility gene (BRCA). Niraparib is recommended as a maintenance treatment for ovarian cancer patients with platinum-sensitive relapse and has been shown to increase progression-free survival. Niraparib was found to enter the brain via the blood-brain barrier, which resulted in a higher concentration of the drug in the brain tissues and better tumor-suppressing effects. There was none report about the applications of PARP inhibitor for endometrial cancer with brain metastases. Here, we present the case of a 62-year-old woman whose Peripheral blood gene detection had shown BRCA1 mutation with brain metastases from high-grade serous carcinoma of the endometrium who was successfully treated with Niraparib and remained free of disease progression for 6 months.
子宫内膜癌（EC）是中国第二常见的妇科恶性肿瘤，近年来其发病率和死亡率均有所上升。EC脑转移极为罕见，仅影响0.3%-1.16%的EC患者。EC脑转移患者的预后较差，从脑转移诊断起的中位生存时间为3.5-6.5个月。尼拉帕利是一种聚（二磷酸腺苷-核糖）聚合酶（PARP）抑制剂，其利用了在乳腺癌易感基因（BRCA）存在突变时的合成致死概念。尼拉帕利被推荐作为铂敏感复发的卵巢癌患者的维持治疗药物，并且已显示可提高无进展生存期。研究发现尼拉帕利可通过血脑屏障进入大脑，这导致脑组织中药物浓度更高且具有更好的肿瘤抑制作用。目前尚无关于PARP抑制剂用于治疗伴有脑转移的子宫内膜癌的报道。在此，我们报告一例62岁女性患者，其外周血基因检测显示BRCA1突变，患有子宫内膜高级别浆液性癌脑转移，经尼拉帕利成功治疗后，疾病无进展达6个月。
