HER2 阳性转移性乳腺癌患者脑转移及生存的预后因素：系统文献复习。
Prognostic factors of brain metastasis and survival among HER2-positive metastatic breast cancer patients: a systematic literature review.
机构信息
Global Medical Affairs, Daiichi Sankyo, Basking Ridge, NJ, USA.
Department of Epidemiology, RTI Health Solutions, Waltham, MA, USA.
出版信息
BMC Cancer. 2021 Aug 28;21(1):967. doi: 10.1186/s12885-021-08708-5.
BACKGROUND
Patients with breast cancer who overexpress the human epidermal growth factor receptor 2 (HER2) and subsequently develop brain metastasis (BM) typically experience poor quality of life and low survival. We conducted a comprehensive literature review to identify prognostic factors for BM and predictors of survival after developing BM, and the effects of therapies with different mechanisms of action among patients with HER2+ breast cancer (BC).
METHODS
A prespecified search strategy was used to identify research studies investigating BM in patients with HER2+ BC published in English during January 1, 2009-to June 25, 2021. Articles were screened using a two-phase process, and data from selected articles were extracted.
RESULTS
We identified 25 published articles including 4097 patients with HER2+ BC and BM. Prognostic factors associated with shorter time to BM diagnosis after initial BC diagnosis included younger age, hormone receptor negative status, larger tumor size or higher tumor grade, and lack of treatment with anti-HER2 therapy. Factors predictive of longer survival after BM included having fewer brain lesions (< 3 or a single lesion) and receipt of any treatment after BM, including radiosurgery, neurosurgery and/or systemic therapy. Patients receiving combination trastuzumab and lapatinib therapy or trastuzumab and pertuzumab therapy had the longest median survival compared with other therapies assessed in this review.
CONCLUSIONS
More research is needed to better understand risk factors for BM and survival after BM in the context of HER2+ BC, as well as the assessment of new anti-HER2 therapy regimens that may provide additional therapeutic options for BM in these patients.
背景
人表皮生长因子受体 2（HER2）过度表达的乳腺癌患者，随后发生脑转移（BM），通常生活质量较差，生存率较低。我们进行了全面的文献回顾，以确定 HER2+乳腺癌（BC）患者 BM 的预后因素和发生 BM 后的生存预测因素，以及不同作用机制的治疗方法对这些患者的影响。
方法
采用预设的搜索策略，检索 2009 年 1 月 1 日至 2021 年 6 月 25 日期间以英文发表的关于 HER2+BC 患者 BM 的研究。采用两阶段流程筛选文章，并提取选定文章的数据。
结果
我们确定了 25 篇已发表的文章，其中包括 4097 例 HER2+BC 和 BM 患者。与初始 BC 诊断后 BM 诊断时间较短相关的预后因素包括年龄较小、激素受体阴性状态、肿瘤较大或肿瘤分级较高，以及缺乏抗 HER2 治疗。与 BM 后生存时间较长相关的因素包括脑转移灶较少（<3 个或单个转移灶）和 BM 后接受任何治疗，包括放射外科手术、神经外科手术和/或全身治疗。与本综述中评估的其他治疗方法相比，接受曲妥珠单抗和拉帕替尼联合治疗或曲妥珠单抗和帕妥珠单抗联合治疗的患者中位生存时间最长。
结论
需要进一步研究，以更好地了解 HER2+BC 背景下 BM 的风险因素和 BM 后的生存情况，以及评估新的抗 HER2 治疗方案，这些方案可能为这些患者的 BM 提供更多的治疗选择。
Zotero 插件