Intrathecal Trastuzumab Treatment in Patients with Breast Cancer and Leptomeningeal Carcinomatosis
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Leptomeningeal carcinomatosis is a fatal manifestation of metastatic breast cancer. Investigation of intrathecal (IT) trastuzumab for leptomeningeal carcinomatosis is currently underway; however, there has been no consensus. We report on two cases of human epidermal growth factor receptor 2 positive (HER2+) breast cancer following IT trastuzumab for leptomeningeal carcinomatosis. The first patient was treated with weekly IT 15 mg methotrexate plus IT 50 mg trastuzumab for 7 months, followed by IT trastuzumab (50 mg > 25 mg) for 18 months. The other patient received IT trastuzumab with systemic chemotherapy (trastuzumab and/or paclitaxel) for 13 months. Good control of leptomeningeal disease was achieved with IT trastuzumab in both patients, with survival durations of 20 and 29 months, respectively. We suggest that IT trastuzumab is a promising treatment for patients with HER2+ breast cancer and leptomeningeal carcinomatosis.
Abstract
Leptomeningeal carcinomatosis is a fatal manifestation of metastatic breast cancer. Investigation of intrathecal (IT) trastuzumab for leptomeningeal carcinomatosis is currently underway; however, there has been no consensus. We report on two cases of human epidermal growth factor receptor 2 positive (HER2+) breast cancer following IT trastuzumab for leptomeningeal carcinomatosis. The first patient was treated with weekly IT 15 mg methotrexate plus IT 50 mg trastuzumab for 7 months, followed by IT trastuzumab (50 mg > 25 mg) for 18 months. The other patient received IT trastuzumab with systemic chemotherapy (trastuzumab and/or paclitaxel) for 13 months. Good control of leptomeningeal disease was achieved with IT trastuzumab in both patients, with survival durations of 20 and 29 months, respectively. We suggest that IT trastuzumab is a promising treatment for patients with HER2+ breast cancer and leptomeningeal carcinomatosis.
참고문헌 (11)
- Grossman SA, "Leptomeningeal carcinomatosis", Cancer Treat Rev, 25, pp.103~119 (1999)
- Jayson GC, "Carcinomatous meningitis in solid tumours", Ann Oncol, 7, pp.773~786 (1996)
- Pienkowski T, "Trastuzumab treatment in patients with breast cancer and metastatic CNS disease", Ann Oncol, 21, pp.917~924 (2010)
- Zagouri F, "Intrathecal administration of trastuzumab for the treatment of meningeal carcinomatosis in HER2-positive metastatic breast cancer : a systematic review and pooled analysis", Breast Cancer Res Treat, 139, pp.13~22 (2013)
- Clarke JL, "Leptomeningeal metastases in the MRI era", Neurology, 74, pp.1449~1454 (2010)
- Baselga J, "Adjuvant trastuz-umab: a milestone in the treatment of HER-2-positive early breast cancer", Oncologist, 11(Suppl 1), pp.4~12 (2006)
- Pestalozzi BC, "Trastuzumab in CSF", J Clin Oncol, 18, pp.2349~2351 (2000)
- Stemmler HJ, "Ratio of trastuzumab levels in serum and cerebrospinal fluid is altered in HER2-positive breast cancer patients with brain metastases and impairment of blood-brain barrier", Anticancer Drugs, 18, pp.23~28 (2007)
- Le Rhun E, "Carcinomatous meningitis : Leptomeningeal metastases in solid tumors", Surg Neurol Int, 4(Suppl 4), pp.265~288 (2013)
- Mir O, "Highdose intrathecal trastuzumab for leptomeningeal metastases secondary to HER-2 overexpressing breast cancer", Ann Oncol, 19, pp.1978~1980 (2008)
- Hofer S, "Intrathecal trastuzumab : dose matters", Acta Oncol, 51, pp.955~956 (2012)