激素受体阳性乳腺癌脑转移药物治疗研究进展

发布时间：2018-02-02 19:52

  本文关键词： 乳腺癌 脑转移 药物治疗 激素受体阳性乳腺癌 综述文献　出处：《中华肿瘤防治杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的乳腺癌是仅次于肺癌最易发生脑转移的原发肿瘤。激素受体阳性乳腺癌是转移性乳腺癌的主体,脑转移是该类患者的主要死亡原因,但目前对于激素受体阳性乳腺癌脑转移(breast cancer brain metastases,BCBM)的有效治疗报道较少。本研究旨探讨激素受体阳性BCBM药物治疗的相关研究进展。方法应用PubMed及CNKI期刊全文数据库检索系统,以"乳腺癌、脑转移和激素受体阳性乳腺癌"等为关键词,检索2005-01-2016-06相关文献,共检测到中文文献128条,英文文献55条。纳入标准:1)BCBM的危险因素及其预后;2)BCBM的当前治疗选择;3)激素受体阳性BCBM药物治疗。根据纳入标准,符合分析的文献25篇。结果限制BCBM药物治疗进展的主要原因是血脑屏障的存在。激素在BCBM治疗中的疗效尚不明确,但有大量个案报道他莫昔芬等内分泌药物对BCBM治疗有效。非对照试验表明某些细胞毒类药物,如卡培他滨、替莫唑胺(temozolomide,TMZ)和卡莫司汀晶片植入剂,对激素受体阳性BCBM有效,但没有足够证据支持具体的治疗方案。免疫抑制剂abemaciclib在激素受体阳性BCBM患者中的应用正处于Ⅱ期临床试验阶段。虽然高分子药物难以通过完整的血脑屏障,但研究证实部分单克隆抗体,如曲妥珠单抗和贝伐单抗,对BCBM治疗有效。纳米药物传递系统能提高中枢神经系统药物转移,有较好发展前景。由纳米颗粒包裹的多柔比星和etirinotecan pegol对治疗激素受体阳性BCBM有一定的疗效。结论尽管目前没有专门批准用于激素受体阳性BCBM系统治疗的药物,但有大量的临床试验正在进行中,将为临床治疗带来启示。
[Abstract]:Objective Breast cancer is the primary tumor which is the most prone to brain metastasis after lung cancer. Hormone receptor positive breast cancer is the main body of metastatic breast cancer. Brain metastasis is the main cause of death in this kind of patients. But at present, for hormone receptor-positive breast cancer, brain metastases of breast cancer brain metastases. The purpose of this study was to investigate the related research progress of hormone receptor positive BCBM drug therapy. Methods PubMed and CNKI periodical full-text database retrieval system were used. Using "Breast Cancer, brain Metastasis and hormone receptor positive Breast Cancer" as the key words, a total of 128 articles were found in Chinese literature from January to June 2016-2005. 55 articles of English literature. The risk factors and prognosis of BCBM were included. 2the current treatment choice of BCBM; 3) steroid receptor positive BCBM drug therapy. According to inclusion criteria. Results the main reason for limiting the progress of drug therapy for BCBM was the existence of blood-brain barrier. The effect of hormone on BCBM was not clear. However, a large number of cases have reported that tamoxifen and other endocrine drugs are effective in the treatment of BCBM. Non-control trials have shown that some cytotoxic drugs, such as capecitabine, temozolomide, temozolomide. TMZ) and carmosine chip implants were effective for hormone receptor positive BCBM. But there is not enough evidence to support the specific treatment plan. The application of immunosuppressant abemaciclib in steroid receptor positive BCBM patients is in the phase 鈪，

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