Akyildiz Arif, Ismayilov Rashad, Abdurrahimli Najmaddin, Ormanci Aylin, Guven Deniz Can, Tuncel Murat, Onur Mehmet Ruhi, Aksoy Sercan
Department of Medical Oncology, Hacettepe University Medical School, Ankara, Turkey.
Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
Jpn J Clin Oncol. 2025 Feb 4;55(2):100-105. doi: 10.1093/jjco/hyae141.
Trastuzumab emtansine (T-DM1) is a novel therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer, combining the targeted action of trastuzumab with the cytotoxic effects of emtansine. Although T-DM1 has demonstrated greater efficacy and safety compared to traditional therapies, concerns about hepatotoxicity and spleen-related complications have arisen.
We conducted a retrospective study of 64 HER2-positive metastatic breast cancer patients treated with T-DM1 at our institution. Patients underwent computed tomography or magnetic resonance imaging at baseline and during treatment cycles. Spleen volume, portal vein diameter, and laboratory values were compared between baseline and 12 months after T-DM1 treatment.
Median spleen volume significantly increased from 201 cm3 (IQR, 157-275) at baseline to 291 cm3 (IQR, 215-420) after 12 months of T-DM1 treatment (P < 0.001). Spleen enlargement was observed in 87.5% of patients, while no significant alteration was detected in portal vein diameter. The change in spleen volume was positively correlated with changes in serum globulin levels, liver enzymes, and bilirubin levels, but did not impact survival outcomes.
T-DM1 therapy in HER2-positive metastatic breast cancer leads to significant spleen enlargement and systemic biochemical changes. Future studies should focus on elucidating the long-term implications of these findings and optimizing monitoring strategies for spleen-related complications.
曲妥珠单抗-恩杂鲁胺（T-DM1）是一种用于治疗人表皮生长因子受体2（HER2）阳性转移性乳腺癌的新型疗法，它将曲妥珠单抗的靶向作用与恩杂鲁胺的细胞毒性作用相结合。尽管与传统疗法相比，T-DM1已显示出更高的疗效和安全性，但人们对其肝毒性和脾脏相关并发症仍存在担忧。
我们对在本机构接受T-DM1治疗的64例HER2阳性转移性乳腺癌患者进行了一项回顾性研究。患者在基线期和治疗周期中接受了计算机断层扫描或磁共振成像检查。比较了基线期和T-DM1治疗12个月后的脾脏体积、门静脉直径和实验室检查值。
T-DM1治疗12个月后，脾脏体积中位数从基线期的201 cm³（四分位间距，157 - 275）显著增加至291 cm³（四分位间距，215 - 420）（P < 0.001）。87.5%的患者出现脾脏肿大，而门静脉直径未发现明显变化。脾脏体积的变化与血清球蛋白水平、肝酶和胆红素水平的变化呈正相关，但不影响生存结果。
HER2阳性转移性乳腺癌患者接受T-DM1治疗会导致脾脏显著肿大和全身生化改变。未来的研究应聚焦于阐明这些发现的长期影响，并优化脾脏相关并发症的监测策略。
