A. Y. Goryainova, S. V. Sharov, O. I. Kirsanova, O. A. Goncharova, R. A. Murashko
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引用次数: 0
摘要
与 HER2/neu 过度表达相关的乳腺癌分子亚型的特点是更频繁、更早地转移到中枢神经系统,这就决定了这类患者的预后不利。由任何部位和组织学结构的肿瘤造成继发性脑损伤的患者是最复杂的患者群体,他们的生活质量极低,需要特别严密的监测和制定个人管理算法。由于临床病程的严重性和对任何治疗干预的耐受性,脑磷脂膜病变的发展使专科医生的任务加倍复杂。人源化抗体免疫球蛋白 G1 和拓扑异构酶 I 抑制剂--埃沙替康衍生物曲妥珠单抗-德鲁替康(T-DXd)--作为一种额外的治疗选择,在实践中的出现为包括中枢神经系统受损患者在内的转移性乳腺癌(mBC)患者带来了新的希望。本文概述了T-DXd在注册研究中的有效性和安全性,展示了在实际临床实践中对一名脑膜受累的HER2阳性(HER2+)mBC患者进行治疗的临床获益。
New treatment options for HER2-positive metastatic breast cancer with leptomeningeal metastases
The molecular subtype of breast cancer associated with overexpression of HER2/neu is characterized by more frequent and earlier metastasis to the central nervous system, predetermining an unfavorable prognosis for patients in this category. Patients with secondary brain damage by tumors of any location and histological structure are the most complex group of patients, demonstrating an extremely low level of quality of life, requiring special close monitoring and the development of a personal management algorithm. The development of leptomeningeal lesions doubly complicates the specialist’s task due to the severity of the clinical course and resistance to any therapeutic interventions. The emergence in practice of a new drug a conjugate of the humanized antibody immunoglobulin G1 and the topoisomerase I inhibitor, the exatecan derivative trastuzumab deruxtecan (T-DXd) as an additional therapeutic option is new hope for patients with metastatic breast cancer (mBC), including those with damage to the central nervous system. This article provides an overview of the effectiveness and safety of T-DXd in registration studies, demonstrating the clinical benefit of therapy in a patient with HER2-positive (HER2+) mBC with meningeal involvement in real-world clinical practice.