Breast cancer brain metastasis: insight into molecular mechanisms and therapeutic strategies

Wang, Yajie; Ye, Fangzhou; Liang, Yiran; Yang, Qifeng

doi:10.1038/s41416-021-01424-8

Cited by 61 publications

(52 citation statements)

References 121 publications

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“…Despite this, trastuzumab levels in the cerebrospinal fluid appear to be low when compared to the therapeutic serum concentration 42 . Aside from the blood‐brain barrier, which may make chemotherapeutics and anti‐HER2 therapy ineffective against brain lesions, HER2+ breast cancer tumor cells can develop molecular mechanisms to avoid anti‐HER2 therapy in the brain 43 . Nevertheless, in a recent metaanalysis, researchers reported a trend toward improved CNS progression‐free survival in patients who had previously undergone RT or neurosurgery to treat brain metastases 32 …”

Section: Discussionmentioning

confidence: 99%

Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer: Real‐world data from a multicentric European cohort

Ratoša

Dobnikar

Bottosso

et al. 2022

Intl Journal of Cancer

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In patients with human epidermal growth factor receptor 2 positive (HER2+) breast cancer, leptomeningeal metastases (LM) are a rare but often a fatal clinical scenario. In this multicentric study, clinical and pathologic characteristics of patients with HER2+ breast cancer developing LM were described, as well as survival outcomes. Data were gathered retrospectively from medical records of 82 patients with advanced HER2+ breast cancer and LM treated between August 2005 and July 2020. Following LM diagnosis, 79 (96.3%) patients received at least one line of anti‐HER2 therapy, 25 (30.5%) patients received intrathecal therapy and 58 (70.7%) patients received radiotherapy. Overall survival (OS) was 8.3 months (95% confidence interval [CI] 5.7‐11), 1‐year OS was 42%, and 2‐year OS was 21%. At univariate analysis, patients who were treated after 2010, had better Karnofsky performance status, were free of neurological symptoms, had better prognostic, received chemotherapy (OS difference 9.4 months, P = .024), or monoclonal antibodies (trastuzumab ± pertuzumab; OS difference 6.1 months; P = .013) after LM diagnosis, had a statistically significantly longer OS. Presence of neurological symptoms (hazard ratio 3.32, 95% CI 1.26‐8.73; P = .015) and not having received radiotherapy (hazard ratio 2.02, 95% CI 1.09‐3.72; P = .024) were all associated with poorer OS at multivariate analysis. To summarize, not having neurological symptoms and receiving RT at LM diagnosis were associated with prolonged OS in our cohort. Survival seemed to be prolonged with multimodality treatment, which included targeted therapy, chemotherapy, and RT to the LM sites.

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Section: Discussionmentioning

confidence: 99%

Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer: Real‐world data from a multicentric European cohort

Ratoša

Dobnikar

Bottosso

et al. 2022

Intl Journal of Cancer

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“…In vitro studies showed that this supported the cancer cells ability to survive and proliferate independent of glucose, thereby employing non-oxidative PPP for purine synthesis [44] . Overall, the degree of metabolic heterogeneity seems generally not to increase or even decrease when comparing primary tumors with their metastatic counterparts [45] , possibly reflecting the result of positive selection within the tumor microenvironment. This is partially unlike what genomics has shown on the increased clonality of the metastasis as compared to the primary tumors, thus warrants investigation.…”

Section: Which Multi-omics Data Layers Should We Consider?mentioning

confidence: 94%

Breast cancer metastasis: Is it a matter of OMICS and proper ex-vivo models?

Cioce

Sacconi²,

Donzelli

et al. 2022

Computational and Structural Biotechnology Journal

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“…BC brain metastasis (BCBM) is a major cause of morbidity of BC patients since many currently available therapies are unable to cross the blood brain barrier (BBB). The BBB is a physiological and morphological barrier that resists most compounds from crossing from the blood to the brain, maintaining the homeostasis of the brain microenvironment ( 69 , 70 ). Therefore, the BBB provides an obstacle to the entry of drugs and other exogenous compounds into the central nervous system.…”

Section: Metastatic Breast Cancer Treatments Via L...mentioning

confidence: 99%

Advances in lipid-based nanocarriers for breast cancer metastasis treatment

Joun

Nixdorf²,

Deng³

2022

Front. Med. Technol.

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Breast cancer (BC) is the most common cancer affecting women worldwide, with over 2 million women diagnosed every year, and close to 8 million women currently alive following a diagnosis of BC in the last 5-years. The side effects such as chemodrug toxicity to healthy tissues and drug resistance severely affect the quality of life of BC patients. To overcome these limitations, many efforts have been made to develop nanomaterial-based drug delivery systems. Among these nanocarriers, lipid-based delivery platforms represented one of the most successful candidates for cancer therapy, improving the safety profile and therapeutic efficacy of encapsulated drugs. In this review we will mainly discuss and summarize the recent advances in such delivery systems for BC metastasis treatment, with a particular focus on targeting the common metastatic sites in bone, brain and lung. We will also provide our perspectives on lipid-based nanocarrier development for future clinical translation.

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Breast cancer brain metastasis: insight into molecular mechanisms and therapeutic strategies

Cited by 61 publications

References 121 publications

Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer: Real‐world data from a multicentric European cohort

Leptomeningeal metastases in patients with human epidermal growth factor receptor 2 positive breast cancer: Real‐world data from a multicentric European cohort

Breast cancer metastasis: Is it a matter of OMICS and proper ex-vivo models?

Advances in lipid-based nanocarriers for breast cancer metastasis treatment

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