Asazuma Kazuki, Shimomura Akihiko, Kawamura Yukino, Taniyama Tomoko, Shimizu Chikako
Department of Breast and Medical Oncology, National Center for Global Health and Medicine, Tokyo, Japan.
Course of Advanced and Specialized Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Case Rep Oncol. 2024 Jul 20;17(1):773-778. doi: 10.1159/000540257. eCollection 2024 Jan-Dec.
Breast cancer is the second most common cause of central nervous system (CNS) metastases. It has been shown that the median time from breast cancer diagnosis to CNS metastasis is 30.9 months and that the overall median survival after metastasis is extremely poor at 6.8 months. Although treatment options for ErbB2 Receptor Tyrosine Kinase 2 (ERBB2)-positive breast cancer brain metastasis (BCBM) have been reported, effective treatment options for ERBB2-negative BCBM, which has one of the worst prognoses, are limited. Olaparib is one of the standard treatments for germline mutated (gmt), ERBB2-negative, metastatic, or recurrent breast cancer. However, there is minimal existing evidence to evaluate the efficacy of olaparib in BCBM.
In our report, we assessed the case of a Japanese woman in her early 30s, ERBB2-negative, gBRAC2mt-positive BCBM, who achieved a complete response and prolonged progression-free survival of 9 months after the initiation of treatment with olaparib.
Thus, our case report demonstrated the significant efficacy of olaparib in BCBM treatment. Furthermore, we highlighted the need for more studies to investigate the efficacy of olaparib and explore the efficacy of poly ADP ribose polymerase inhibitors in BCBM.
乳腺癌是中枢神经系统（CNS）转移的第二大常见原因。研究表明，从乳腺癌诊断到CNS转移的中位时间为30.9个月，转移后的总体中位生存期极差，仅为6.8个月。尽管已有关于表皮生长因子受体2（ERBB2）阳性乳腺癌脑转移（BCBM）的治疗方案报道，但预后最差的ERBB2阴性BCBM的有效治疗方案有限。奥拉帕利是种系突变（gmt）、ERBB2阴性、转移性或复发性乳腺癌的标准治疗方法之一。然而，现有证据极少能用于评估奥拉帕利在BCBM中的疗效。
在我们的报告中，我们评估了一名30岁出头的日本女性患者的病例，该患者为ERBB2阴性、生殖系BRCA2突变（gBRAC2mt）阳性的BCBM，在开始使用奥拉帕利治疗后实现了完全缓解，并将无进展生存期延长至9个月。
因此，我们的病例报告证明了奥拉帕利在BCBM治疗中的显著疗效。此外，我们强调需要更多研究来调查奥拉帕利的疗效，并探索聚ADP核糖聚合酶抑制剂在BCBM中的疗效。
