Intrathecal trastuzumab for leptomeningeal carcinomatosis in patients with human epidermal growth factor receptor 2 positive breast cancer.
There has been recent increase in incidence of leptomeningeal carcinomatosis, possibly due to widespread use of adjuvant trastuzumab and its known poor CNS penetration. Currently there are limited therapeutic options for these patients and outcome is poor. We report two cases of women with HER2 positive breast cancer who developed leptomeningeal carcinomatosis for which they were treated with intrathecal trastuzumab in combination with systemic therapy. Both patients had rapid symptomatic benefit and radiological response and remained progression free for at least seven months. Intrathecal trastuzumab can be considered a reasonable therapeutic option for these difficult to treat patients.
Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Seema
S
Gulia
Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Sudeep
S
Gupta
Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Ashish
A
Singh
Her 2 positive breast cancer intrathecal trastuzumab; leptomeningeal carcinomatosis
Cancer. 1983 Dec 15;52(12):2349-54
6640506
J Clin Oncol. 2003 Nov 1;21(21):3965-71
14507946
Ann Oncol. 2010 Nov;21(11):2183-7
20430906
Breast Cancer Res Treat. 2013 May;139(1):13-22
23588955
J Clin Oncol. 2000 Jun;18(11):2349-51
10829059
J Neurooncol. 2011 Sep;104(2):565-72
21234642
Ann Oncol. 2008 Nov;19(11):1978-80
18845838
Acta Oncol. 2012 Sep;51(7):955-6
22524214
Anticancer Drugs. 2007 Jan;18(1):23-8
17159499