Bevacizumab might potentiate the chemotherapeutic effect in breast cancer patients with leptomeningeal carcinomatosis
Journal
Journal of the Formosan Medical Association
Journal Volume
115
Journal Issue
4
Pages
243-248
Date Issued
2016
Abstract
Background/purpose: Patients with leptomeningeal carcinomatosis (LC) from breast cancer is generally resistant to systemic chemotherapy. Bevacizumab may increase intratumor concentration of the chemotherapeutic agents through vascular normalization, although the overall clinical benefit of bevacizumab for metastatic breast cancer is under debate. Methods: Successful treatment of two breast cancer patients who developed LC after whole brain irradiation treatment for the brain metastases is reported here. Both patients have refractory disease to taxane and anthracycline, and both of them have disease progression under intrathecal methotrexate treatment for LC. Results: The two patients received systemic chemotherapy with bevacizumab (7.5 mg/kg infusion on Day 1), cisplatin (80 mg/m2 infusion for 24 hours on Day 2), and etoposide (80 mg/m2 infusion for 2 hours on Days 2-4) at 21-28 day intervals. Both patients achieved best response of negative cerebral spinal fluid cytology study and dramatic improvement of neurologic deficit after treatment. Their overall survival after development of LC was 8 months and 7.5 months respectively. Conclusion: Bevacizumab plus etoposide and cisplatin might be a new option for breast cancer patients with LC. Further prospective study is warranted. ? 2015 Formosan Medical Association.
SDGs
Other Subjects
bevacizumab; capecitabine; cisplatin; cyclophosphamide; docetaxel; epirubicin; etoposide; methotrexate; navelbine; paclitaxel; UFT; valproic acid; angiogenesis inhibitor; antineoplastic agent; bevacizumab; cisplatin; etoposide; adult; Article; brain metastasis; brain radiation; breast cancer; breast carcinoma; breast metastasis; cancer combination chemotherapy; cancer radiotherapy; carcinomatous meningitis; case report; cerebrospinal fluid analysis; computer assisted tomography; cytology; drug potentiation; female; human; middle aged; multiple cycle treatment; Ommaya reservoir; overall survival; seizure; stereotactic radiosurgery; treatment response; brain; breast tumor; diagnostic imaging; fatality; Meningeal Carcinomatosis; nuclear magnetic resonance imaging; pathology; secondary; x-ray computed tomography; Adult; Angiogenesis Inhibitors; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Brain; Breast Neoplasms; Cisplatin; Etoposide; Fatal Outcome; Female; Humans; Magnetic Resonance Imaging; Meningeal Carcinomatosis; Middle Aged; Tomography, X-Ray Computed
Publisher
Elsevier B.V.
Type
journal article