Valerio Maria Rosaria, Cipolla Calogero, Greco Martina, Mesi Chiara, Modica Francesca, Gebbia Vittorio, Scandurra Giuseppa, Sambataro Daniela
Medical Oncology Unit, University Hospital "Policlinico P. Giaccone," University of Palermo, Palermo, Italy.
Breast Unit, University Hospital "Policlinico P. Giaccone," University of Palermo, Palermo, Italy.
Ther Adv Med Oncol. 2025 Mar 28;17:17588359251317847. doi: 10.1177/17588359251317847. eCollection 2025.
Patients with luminal breast cancer (BC) may develop central nervous system metastases in 20%-40% of cases. Radiation or surgical therapy represents the cornerstone of treating central nervous system metastases. Meanwhile, the best practice for metastatic luminal BC involves using cyclin-dependent kinase 4/6 inhibitors combined with endocrine therapy. To our knowledge, this is the first case to report a dramatic response of breast metastases to abemaciclib plus endocrine therapy without radiation therapy, particularly in a patient who presented with seizures and sudden coma. She received brain surgery to control a large bleeding metastasis. Abemaciclib was crushed and diluted in water for administration via the nasogastric tube, while an upfront fulvestrant was given since aromatase inhibitors cannot be diluted. Beyond the radiological response, the clinical improvement was notable, with complete symptom recovery to the point where she is again working. Our paper supports the activity of abemaciclib in brain metastases from luminal BC and includes a review of the medical literature. Further investigation is warranted in this clinical setting.
管腔型乳腺癌（BC）患者中，20%-40%的病例可能发生中枢神经系统转移。放疗或手术治疗是治疗中枢神经系统转移的基石。同时，转移性管腔型BC的最佳治疗方法是使用细胞周期蛋白依赖性激酶4/6抑制剂联合内分泌治疗。据我们所知，这是首例报告在未进行放射治疗的情况下，阿贝西利联合内分泌治疗对乳腺转移瘤产生显著反应的病例，特别是对于一名出现癫痫发作和突然昏迷的患者。她接受了脑部手术以控制大量出血性转移瘤。阿贝西利被碾碎并用水稀释后经鼻胃管给药，由于芳香化酶抑制剂不能稀释，因此预先给予了氟维司群。除了影像学反应外，临床改善也很显著，症状完全恢复，以至于她又重新开始工作。我们的论文支持阿贝西利在管腔型BC脑转移中的活性，并对医学文献进行了综述。在这种临床情况下，有必要进行进一步的研究。
