Division of Medical Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC.
Division of Medical Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC; Division of Medical Oncology, Duke Center for Brain and Spine Metastasis, Duke University Medical Center, Durham, NC.
Clin Breast Cancer. 2023 Dec;23(8):825-831. doi: 10.1016/j.clbc.2023.07.008. Epub 2023 Aug 4.
The treatment of metastatic breast cancer (MBC) has improved over the past decade, however prognosis continues to be mitigated by the fact that about 1 in 5 patients with MBC will develop brain metastases (BrM) during their metastatic disease course. 1 This number is even higher for patients with triple-negative breast cancer (TNBC), with studies showing as high as 40% of patients developing BrM. 2, 3 Studies have shown that TNBC portends a worse survival after a diagnosis of BrM compared with non-TNBC subtypes. 4 Given the unique location and biologic properties of BrM, treatment options have historically been limited. Challenges to the treatment of TNBC BrM include a lack of targeted therapies and difficulties in delivery of drug to the brain past the blood-brain barrier (BBB). Herein, we will review the advances in local and systemic therapies to most effectively treat patients with TNBC BrM, including therapies on the horizon currently in clinical trials.
在过去的十年中,转移性乳腺癌(MBC)的治疗已经得到了改善,然而,大约每 5 名 MBC 患者中就有 1 名会在转移性疾病过程中发展为脑转移(BrM),这一事实仍使预后恶化。1 对于三阴性乳腺癌(TNBC)患者来说,这一数字甚至更高,有研究显示高达 40%的患者会发生 BrM。2,3 研究表明,与非 TNBC 亚型相比,TNBC 在诊断为 BrM 后生存预后更差。4 鉴于 BrM 的独特位置和生物学特性,治疗选择历来受到限制。TNBC BrM 治疗面临的挑战包括缺乏靶向治疗以及药物难以穿透血脑屏障(BBB)进入大脑。在此,我们将回顾局部和全身治疗的进展,以最有效地治疗 TNBC BrM 患者,包括目前正在临床试验中的潜在疗法。