PDF(Pubmed)
Abstract：
Breast cancer with brain metastasis accounts for the second largest number of brain metastases among solid malignancies. Despite advances in HER2-targeted therapy, 50% of patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer develop brain metastases and are associated with poor outcomes. In this article, we report the case of a patient with HER2+ metastatic breast cancer who developed brain metastases, despite experiencing a durable effect on extracranial metastases after treatment with trastuzumab and pertuzumab. The patient exhibited intracranial progression while receiving treatment with trastuzumab deruxtecan monotherapy after secondary brain radiotherapy and multiple lines of therapy with anti-HER2 agents, such as pyrotinib, lapatinib, tucatinib, and ado-trastuzumab emtansine. However, the administration of anlotinib (an antiangiogenesis medication) and trastuzumab deruxtecan resulted in intracranial and extracranial partial response and was linked to manageable side effects. The present case indicates that the combination of anlotinib and trastuzumab deruxtecan may be a promising treatment option for patients with HER2+ breast cancer with brain metastasis. Nevertheless, further studies are warranted to verify the present findings.
摘要：
在实体恶性肿瘤中，具有脑转移的乳腺癌占第二大数量的脑转移。尽管HER2靶向治疗取得了进展，50％的人表皮生长因子受体2阳性（HER2+）乳腺癌患者发生脑转移，并与不良预后相关。在这篇文章中,我们报道一例HER2+转移性乳腺癌患者发生脑转移,尽管使用曲妥珠单抗和帕妥珠单抗治疗后对颅外转移有持久的影响.患者在接受二次脑放疗和抗HER2药物多线治疗后接受曲妥珠单抗deruxtecan单药治疗时表现出颅内进展。如吡唑替尼，拉帕替尼,图卡替尼,和ado-曲妥珠单抗emtansine.然而,安洛替尼(抗血管生成药物)和曲妥珠单抗deruxtecan的给药导致颅内和颅外部分反应,并与可控的副作用相关.目前的情况表明，安洛替尼和曲妥珠单抗德鲁克替康的组合可能是HER2+乳腺癌脑转移患者的有希望的治疗选择。然而，需要进一步的研究来验证本研究结果.
