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乳腺癌脑转移的药物治疗:进展与挑战

Drug treatment of breast cancer brain metastases: progress and challenges.

作者信息

Luo Jialing, Ren Aixiong, Si Dikun, Yang Jixin, Xu Dongdong, Li Nanlin

机构信息

Department of Thyroid, Breast and Vascular Surgery, The First Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi Province, China.

出版信息

Discov Oncol. 2025 Jun 7;16(1):1025. doi: 10.1007/s12672-025-02820-9.

Abstract

Breast cancer is one of the most prevalent malignancies among women worldwide, with brain metastasis occurring in approximately 10-16% of cases, significantly contributing to poor prognosis and reduced quality of life. The treatment of breast cancer brain metastasis requires a multidisciplinary approach, prioritizing local therapies such as surgery and radiotherapy to address central nervous system lesions. However, local treatments often struggle to effectively control the progression of brain metastases and are associated with multiple complications, necessitating adjunctive systemic and supportive therapies. Following local therapy, breast cancer brain metastasis patients may benefit from systemic treatments. Pharmacological therapies, including chemotherapy, targeted therapy, immunotherapy, and antibody-drug conjugates, have emerged as vital strategies for breast cancer brain metastasis treatment. Targeted therapies combined with stereotactic radiosurgery and surgical resection have shown improved survival rates. However, challenges remain, such as high costs, limited availability of radiotherapy equipment, and individualized treatment requirements based on lesion characteristics and systemic disease control. Further advancements in pharmacological options, particularly targeted and immune therapies, offer promising avenues for improving outcomes and survival in breast cancer brain metastasis patients.

摘要

乳腺癌是全球女性中最常见的恶性肿瘤之一,约10%-16%的病例会发生脑转移,这显著导致预后不良和生活质量下降。乳腺癌脑转移的治疗需要多学科方法,优先采用手术和放疗等局部治疗来处理中枢神经系统病变。然而,局部治疗往往难以有效控制脑转移的进展,且伴有多种并发症,因此需要辅助性的全身治疗和支持治疗。在局部治疗后,乳腺癌脑转移患者可能从全身治疗中获益。包括化疗、靶向治疗、免疫治疗和抗体药物偶联物在内的药物治疗已成为乳腺癌脑转移治疗的重要策略。靶向治疗联合立体定向放射外科手术和手术切除已显示出生存率的提高。然而,挑战依然存在,如成本高昂、放疗设备供应有限以及基于病变特征和全身疾病控制的个体化治疗需求。药物治疗选择的进一步进展,特别是靶向治疗和免疫治疗,为改善乳腺癌脑转移患者的治疗效果和生存率提供了有希望的途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1b0/12145366/aeb10a4a7a61/12672_2025_2820_Fig1_HTML.jpg

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