Dose-Intensive Chemotherapy for Breast Cancer With Brain Metastases

Fleming, Donald R.; Goldsmith, George C.; Stevens, Don A.; Herzig, Roger H.

doi:10.1097/00000421-199908000-00009

Cited by 2 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The small number of patients in most trials makes it difficult to identify factors that influence survival. Prognostic factors identified in breast cancer patients with brain metastases who were treated with radiotherapy [4] appear to apply to patients treated with chemotherapy as well: They include response to treatment as predictor of survival [47] and longer survival of patients with hormone receptor-positive primary tumors [48]. Most trials reported objective responses in extracranial metastatic sites [46], and this may be important for overall survival.…”

Section: Clinical Trials For Chemotherapy In Breast Cancer Brain Metamentioning

confidence: 99%

See 1 more Smart Citation

Chemotherapy for Breast Cancer Brain Metastases

Fenner

Possinger²

2002

Oncol Res Treat

View full text Add to dashboard Cite

Breast cancer is the second most common cause of brain metastases, and 10–15% of patients develop clinically overt central nervous system disease. Radiotherapy is the standard treatment for patients with brain metastases. Surgical resection should be considered in patients with isolated brain metastasis and no extracranial disease. The role of chemotherapy in breast cancer brain metastases is not clearly defined; the results of the 8 trials found in the literature are reported. Most experience has been gained with the CMF (cyclophosphamide, methotrexate and fluorouracil) and PE (cisplatin and etoposide) regimens; here the median survival of 6 months is similar to radiotherapy. The blood-brain barrier, maintained by tight endothelial junctions and active transport mechanisms, is a major reason for the lower activity of most chemotherapeutic agents compared to other sites of metastatic disease. Most substances with good penetration of the blood-brain barrier have limited activity against breast cancer and some of the most active substances in breast cancer – including doxorubicine, the taxanes and trastuzumab – appear not to reach the central nervous system in sufficient concentrations. Approaches to overcome the blood-brain barrier are still experimental, and more research is clearly needed to identify chemotherapeutic agents both active in breast cancer and with good penetration of the blood-brain barrier. With the exception of patients with resectable brain metastases, danger of cranial herniation or poor general condition, chemotherapy should be offered to breast cancer patients with brain metastases that have progressive extracranial metastatic disease or relapse after radiotherapy.

show abstract

Section: Clinical Trials For Chemotherapy In Breast Cancer Brain Metamentioning

confidence: 99%

“…Fleming et al [48] analyzed the outcome of the treatment of 11 patients with brain metastases who received high-dose chemotherapy. The median survival was similar to patients without brain metastases, and isolated central nervous system progression was not observed.…”

Section: High-dose Chemotherapymentioning

confidence: 99%

Chemotherapy for Breast Cancer Brain Metastases

Fenner

Possinger²

2002

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

Current Concepts and Controversies in the Treatment of Parenchymal Brain Metastases: Improved Outcomes with Aggressive Management

Bajaj

Kleinberg

Terezakis

2005

Cancer Investigation

View full text Add to dashboard Cite

The multimodality management of brain metastases has undergone significant refinement in the last decade. Although brain metastases remain a significant source of morbidity and mortality for many cancer patients, aggresive management has led to pronounced gains in neurological functioning, disease free survival and overall survival compared to standard treatment regimens consisting of only whole brain radiation therapy. Representative studies reviewing the role of aggressive management approaches including surgical resection with or without whole brain radiation therapy or non-surgical approaches employing stereotactic radiosurgery alone or in combination with whole brain radiation therapy are highlighted. Additionally, the emerging role of systemic agents showing distinct clinical activity in patients with brain metastases are also discussed. As we continue to gain advances in systemic therapies for metastatic disease, local control of brain metastases in these patients is likely to become more critical in improving survival and quality of life, thereby calling for a more aggressive multi-modal approach to this population of patients.

show abstract

Dose-Intensive Chemotherapy for Breast Cancer With Brain Metastases

Cited by 2 publications

References 33 publications

Chemotherapy for Breast Cancer Brain Metastases

Chemotherapy for Breast Cancer Brain Metastases

Current Concepts and Controversies in the Treatment of Parenchymal Brain Metastases: Improved Outcomes with Aggressive Management

Contact Info

Product

Resources

About