Zhang Qiongwen, Yan Xi, Tian Ting-Lun, Wu Xin
Department of Head and Neck Oncology, Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
Breast Disease Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2024 Aug 19;15:1381478. doi: 10.3389/fphar.2024.1381478. eCollection 2024.
Brain metastases (BM) represent a common and severe complication of breast cancer (BC), emerging in approximately 10%-16% of all BC patients. The prevalent approach for treating BC patients with BM encompasses a multimodal strategy, combining surgery, whole brain radiation therapy, and stereotactic radiosurgery. Yet, a concrete guideline for localized treatment strategies remains elusive, while systemic treatments like small-molecule-targeted therapy and immunotherapy are still in the clinical trial phase. This case study presents a significant clinical response to anlotinib treatment in a patient with estrogen receptor-negative, progesterone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-positive breast cancer, complicated by BM. After the standard first-line treatment including albumin-bound paclitaxel, trastuzumab and pertuzumab, and a second-line treatment involving pyrotinib, capecitabine, and radiotherapy did not produce the desired results, the patient was then administered anlotinib in combination with pyrotinib and letrozole as a third-line treatment, which led to a partial response (PR). The findings suggest that anti-angiogenic therapy, specifically anlotinib, could be regarded as a promising therapeutic option for BC patients with BM.
脑转移(BM)是乳腺癌(BC)常见且严重的并发症,约10%-16%的BC患者会出现。治疗BC合并BM患者的常用方法是多模式策略,包括手术、全脑放射治疗和立体定向放射外科手术。然而,局部治疗策略的具体指南仍不明确,而小分子靶向治疗和免疫治疗等全身治疗仍处于临床试验阶段。本病例研究展示了一名雌激素受体阴性、孕激素受体阳性且人表皮生长因子受体2(HER2)阳性的BC合并BM患者对安罗替尼治疗有显著临床反应。在包括白蛋白结合型紫杉醇、曲妥珠单抗和帕妥珠单抗的标准一线治疗以及包括吡咯替尼、卡培他滨和放疗的二线治疗均未取得预期效果后,该患者接受了安罗替尼联合吡咯替尼和来曲唑作为三线治疗,结果产生了部分缓解(PR)。研究结果表明,抗血管生成治疗,特别是安罗替尼,可被视为BC合并BM患者有前景的治疗选择。