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乳腺癌脑转移——疾病状态、治疗选择及未来展望概述

Breast Cancer Brain Metastasis-Overview of Disease State, Treatment Options and Future Perspectives.

作者信息

Watase Chikashi, Shiino Sho, Shimoi Tatsunori, Noguchi Emi, Kaneda Tomoya, Yamamoto Yusuke, Yonemori Kan, Takayama Shin, Suto Akihiko

机构信息

Department of Breast Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan.

Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan.

出版信息

Cancers (Basel). 2021 Mar 3;13(5):1078. doi: 10.3390/cancers13051078.

Abstract

Breast cancer is the second most common origin of brain metastasis after lung cancer. Brain metastasis in breast cancer is commonly found in patients with advanced course disease and has a poor prognosis because the blood-brain barrier is thought to be a major obstacle to the delivery of many drugs in the central nervous system. Therefore, local treatments including surgery, stereotactic radiation therapy, and whole-brain radiation therapy are currently considered the gold standard treatments. Meanwhile, new targeted therapies based on subtype have recently been developed. Some drugs can exceed the blood-brain barrier and enter the central nervous system. New technology for early detection and personalized medicine for metastasis are warranted. In this review, we summarize the historical overview of treatment with a focus on local treatment, the latest drug treatment strategies, and future perspectives using novel therapeutic agents for breast cancer patients with brain metastasis, including ongoing clinical trials.

摘要

乳腺癌是继肺癌之后脑转移的第二大常见原发肿瘤。乳腺癌脑转移常见于病程晚期的患者,且预后较差,因为血脑屏障被认为是许多药物进入中枢神经系统的主要障碍。因此,包括手术、立体定向放射治疗和全脑放射治疗在内的局部治疗目前被视为金标准治疗方法。与此同时,最近基于亚型的新靶向治疗方法也已开发出来。一些药物能够突破血脑屏障并进入中枢神经系统。早期检测新技术和转移瘤个性化医疗很有必要。在本综述中,我们总结了以局部治疗为重点的治疗历史概况、最新的药物治疗策略,以及使用新型治疗药物治疗乳腺癌脑转移患者的未来展望,包括正在进行的临床试验。

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