乳腺癌脑转移的治疗进展——治疗分子机制及多学科综合治疗策略  

Progress in the treatment of breast cancer with brain metastasis——therapeutic molecular mechanisms and multi-disciplinary treatment strategy

作　　者：张艳[1] 夏天麒 周洋洋 陈惠东 徐溢 孙勇 胡建 沈赞[1] Zhang Yan;Xia Tianqi;Zhou Yangyang;Chen Huidong;Xu Yi;Sun Yong;Hu Jian;Shen Zan(Department of Oncology,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China;Department of Medical Oncology,Shanghai Jiao Tong University Affiliated Sixth People′s Hospital East Campus,Shanghai 201306,China;UTMD Anderson Cancer Center,Houston 77030,USA)

机构地区：[1]上海交通大学医学院附属第六人民医院肿瘤科,上海200080 [2]上海交通大学附属第六人民医院东院肿瘤内科,上海201306 [3]德克萨斯大学安德森癌症中心,美国休斯敦77030

出　　处：《中华转移性肿瘤杂志》2023年第4期444-450,共7页Chinese Journal of Metastatic Cancer

摘　　要：转移性乳腺癌的治疗在过去的10年中有所改善,但由于约20%的患者在其转移性病程中会发生脑转移,缺乏有效的治疗方法,是导致死亡的主要原因。本文根据指南从影像诊断、病理诊断、脑脊液活检、放疗、药物治疗等多方面进行回顾,就乳腺癌脑转移(BCBM)全程管理中的热点问题提出了BCBM肿瘤整合诊疗流程。鉴于脑转移独特的位置和生物学特性,介绍了阻碍药物进入大脑的各种屏障。为推进研发治疗BCBM患者新型有效的靶向疗法,描述了正在进行的药物靶点的临床试验,并寻求利用更高效和更有前途的药物传递系统来改善脑给药。同时呈现了早期监测诊断BCBM的影像临床试验和脑脊液液态活检,期待有助于改善患者预后的多学科诊疗进展。The treatment of metastatic breast cancer(MBC)has improved over the past decade.However,the prognosis remains unsatisfied by the fact that about 20%of MBC patients develop breast cancer brain metastases(BCBM)during their metastatic disease course without effective therapies,resulting in the leading cause of death among MBC.According to the guidelines,we review imageological diagnosis,pathological diagnosis,cerebrospinal fluid biopsy,radiotherapy,therapy and propose integrated diagnosis and treatment process based on hot issues in the whole management of BCBM.Given the unique location and biologic properties of BCBM,we introduce several brain barriers with limited permeability for drugs.In this review,we also describe ongoing clinical trials on druggable targets in BCBM for developing novel and efficacious targeted therapies and look to improving brain drug delivery using more efficient and promising drug delivery systems.Meanwhile,we present current clinical trials for early detection or diagnosis of BCBM by imageological examination and cerebrospinal fluid biopsy,looking forward to enhancing the effectiveness of multidisciplinary treatment and improving the prognosis of BCBM patients.

关 键 词：治疗靶点 临床试验 系统治疗 血脑屏障 血肿瘤屏障 

分 类 号：R737.9[医药卫生—肿瘤]