Meningeal carcinomatosis from breast cancer treated with intrathecal trastuzumab

Platini, Christian; Long, Jérôme; Walter, Sabine

doi:10.1016/s1470-2045(06)70864-6

Cited by 83 publications

(50 citation statements)

References 8 publications

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“…No clear clinical benefit could be documented, but there were no side effects other than mild local ventricle inflammation at autopsy [10]. This led others to administer IT trastuzumab [11][12][13][14][15][16][17]. Most patients experienced symptoms improvement and no adverse neurological effects.…”

Section: Discussionmentioning

confidence: 99%

“…No consensus exists on the adequate dosing and frequency of IT trastuzumab, ranging from 5mg [10,17] to 100mg [14] dosing in a weekly [10,[13][14][15][16][17] to every three weeks [11,13] schedule, with 25mg…”

Section: Discussionmentioning

confidence: 99%

“…(assessed by recurrence of positive CSF cytology) ranged from 2 [10] to 24 [13] months and survival after LC diagnosis from 3 [10] to 26 [15] months.…”

Section: Discussionmentioning

confidence: 99%

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Complete response in HER2+ leptomeningeal carcinomatosis from breast cancer with intrathecal trastuzumab

Oliveira¹,

Braga

Passos‐Coelho³

et al. 2011

Breast Cancer Res Treat

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Trastuzumab, a monoclonal antibody against the HER2 receptor, is a major breakthrough in the treatment of HER2+ breast cancer. However, its high molecular weight precludes it from crossing the intact blood-brain barrier, making the central nervous system a sanctuary to HER2+ breast cancer metastases. We prospectively assessed functional outcome and toxicity of administering trastuzumab directly into the cerebrospinal fluid of a patient with leptomeningeal carcinomatosis and brain metastases from HER2+ breast cancer that had already been treated with other intrathecal chemotherapy, with no benefit. Upon signed informed consent, weekly lumbar puncture with administration of trastuzumab 25mg was begun to a 44 year-old women with metastatic breast cancer (lymph node, bone, lung and liver involvement) previously treated with tamoxifen, letrozole, anthracyclines, taxanes, capecitabine, intravenous trastuzumab and lapatinib. She received 67 weekly administrations of intrathecal trastuzumab with marked clinical improvement and no adverse events. She survived 27 months after leptomeningeal carcinomatosis diagnosis.A complete leptomeningeal response, with no evidence of leptomeningeal metastasis at necropsy, was achieved. We believe that intrathecal trastuzumab administration should be prospectively evaluated to confirm clinical activity and optimize dose, schedule and duration of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Complete response in HER2+ leptomeningeal carcinomatosis from breast cancer with intrathecal trastuzumab

Oliveira¹,

Braga

Passos‐Coelho³

et al. 2011

Breast Cancer Res Treat

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“…Recent evidence suggests that CM originating from lung cancer could be treated with gefitinib (25,10,7,18) and high-dose erlotinib (19) One study also suggested that trastuzumab may benefit some CM patients who had breast cancer (11). Recently, several authors reported successful treatment of meningeal carcinomatosis by intrathecal trastuzumab (17,22,26). Some studies indicate that radiotherapy (whole brain and involved-field irradiation of bulky spinal lesions) and chemotherapy (systemically or intrathecally applied methotrexate, thiotepa, and cytarabine) are both effective and may prolong survival from several weeks to 4-6 months in patients with CM (8, 4).…”

Section: Duan H Et Al: Carcinomatous Meningitis In the Chinese Populmentioning

confidence: 99%

Clinical features of patients with carcinomatous meningitis in the chinese population: report of 4 cases and review of literature

Duan¹,

Li²,

Sun³

2012

Turkish Neurosurgery

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AIm: Carcinomatous meningitis (CM) is a rare neurological disorder. We aim to promote the diagnostic efficiency of CM. BulGulAr: KM akut veya subakut belirtilerle ortaya çıkabilir. İntrakraniyal hipertansiyon ve meningeal iritasyon bulguları KM hastalarında sıktı. Başka belirtiler arasında boyun ve oksipital ağrı, tek taraflı alt uzuv zayıflığı ve kraniyal sinir anormallikleri vardı. Diğer olağandışı belirtiler arasında görme bozukluğu (2 olgu), bilateral sensörinöral işitme kaybı (1 olgu) ve her iki kulakta sürekli uğuldama (1 olgu) vardı. MRG 3 olguda meninkslerin kontrast tuttuğunu gösterdi. BOS sitolojisi 2 olguda kanser hücreleri açısından pozitifti. Hastaların sağkalımı 18 gün ile 8 ay arasındaydı.sOnuÇ: KM hastaları çeşitli belirtilerle gelebilir. Serum tümör biyobelirteci saptanması, BOS sitolojisi ve kontrastlı MRG tarama KM tanısında şarttır.

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“…14,17 The duration of disease control from the initiation of intrathecal trastuzumab ranged from 39 days to greater than 72 months, with 6 patients surviving greater than 5 months. [12][13][14][15][16][17] Interestingly, the patient who died at day 39 of intrathecal trastuzumab treatment died due to progression of visceral metastases and was considered to be in remission with regard to the leptomeningeal carcinomatosis. 10 Tumor cell counts were also found to be eliminated or substantially decreased in 4 of 5 patients.…”

Section: -17mentioning

confidence: 99%

Role of Intrathecal Rituximab and Trastuzumab in the Management of Leptomeningeal Carcinomatosis

Perissinotti

Reeves

2010

Ann Pharmacother

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Meningeal carcinomatosis from breast cancer treated with intrathecal trastuzumab

Cited by 83 publications

References 8 publications

Complete response in HER2+ leptomeningeal carcinomatosis from breast cancer with intrathecal trastuzumab

Complete response in HER2+ leptomeningeal carcinomatosis from breast cancer with intrathecal trastuzumab

Clinical features of patients with carcinomatous meningitis in the chinese population: report of 4 cases and review of literature

Role of Intrathecal Rituximab and Trastuzumab in the Management of Leptomeningeal Carcinomatosis

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