Intrathecal Trastuzumab for Meningeal Carcinomatosis Secondary to HER2-Overexpressing Breast Cancer

乳癌腦脊椎膜轉移個案脊髓腔內注射Trastuzumab報告

陳彥勳(Yen-Hsun Chen) ； 黃偉修(Wei-Shiou Hwang) ； 陳昭勳(Chao-Hsun Chen) ； 曹朝榮(Chao-Jung Taso) ； 黃文聰(Wen-Tsung Huang) ； 林明賢(Ming-Hsien Lin) ； 馮盈勳(Yin-Hsun Feng) ； 林建良(Chien-Liang Lin) ； 林正耀(Cheng-Yao Lin) ； 陳尚文(Shang-Wen Chen) ； 陳尚鴻(Shang-Hung Chen)

《中華民國癌症醫學會雜誌》 25卷5期 (2009/10) Pp. 357-364

https://doi.org/10.6588/JCOS.2009.25.5.6

摘要

我們報告一名五十七歲罹患乳癌伴肺部，肝臟及脊椎膜轉移之病人。她接受脊髓腔內注射methotrexate作為起始治療，但白血球降低並且神經學症狀改善有限。她接受脊髓腔內注射trastuzumab之治療，神經學症狀改善尤其是吞嚥困難跟意識狀況部份。但兩個月後症狀再度惡化，她接受調高劑量trastuzumab脊髓腔內治療，神經學症狀改善並且未有明顯副作用。細胞學檢查亦持續陰性結果。本文也回顧脊髓腔內注射trastuzumab腦脊椎膜轉移之文獻。

關鍵字

脊髓腔內trastuzumab ； 乳癌 ； 腦脊椎膜轉移

並列摘要

We report a 57-year-old woman with left breast cancer with lung, liver, and leptomeningeal metastasis. She received methotrexate (MTX) intrathecal injection for initial therapy, but neutropenia occurred and her neurological symptoms improved only mildly. She received intrathecal trastuzumab of 20 mg bi-weekly, and neurological symptoms improved gradually, especially dysphagia and consciousness. However, neurological symptoms worsened two months later. Intrathecal trastuzumab of 85~100 mg was given weekly, and neurological symptoms improved again. No obvious side effect was observed, and persistence of tumor-negative CSF cytology was noted after that. We also review the literature regarding intrathecal trastuzumab for leptomeningeal carcinomatosis.

並列關鍵字

intrathecal trastuzumab ； breast cancer ； leptomeningeal carcinomatosis