medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-9-164-170medsovet-6929Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONРибоциклиб в лечении гормонопозитивного HER2-негативного рака молочной железы с метастатическим поражением головного мозга: клиническое наблюдениеRibociclib in patient with hormone-positive HER2-negative breast cancer with brain metastases: a case reporthttps://orcid.org/0000-0002-6244-9159ПризоваН. С.PrizovaN. S.

Призова Наталия Сергеевна – кандидат медицинских наук, врач-онколог отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 9563-3579

Natalia S. Prizova - Cand. Sci. (Med.), Oncologist of Chemotherapy Department, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

sonrisa3n@mail.ruhttps://orcid.org/0000-0003-4879-2687БолотинаЛ. В.BolotinaL. V.

Болотина Лариса Владимировна – доктор медицинских наук, заведующая отделением химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 2787-5414

Larisa V. Bolotina - Dr. Sci. (Med.), Head of Chemotherapy Department, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

lbolotina@yandex.ruhttps://orcid.org/0000-0003-0092-0459КорниецкаяА. Л.KornietskayaA. L.

Корниецкая Анна Леонидовна - кандидат медицинских наук, старший научный сотрудник отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 2651-7158

Аnna L. Kornietskaya - Cand. Sci. (Med.), Senior Researcher of the Department of Chemotherapy, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

kornietskaya@mail.ruМосковский научно-исследовательский онкологический институт имени П.А. ГерценаРоссияHertsen Moscow Oncology Research InstituteRussian Federation20221906202209164170Copyright © Призова Н.С., Болотина Л.В., Корниецкая А.Л., 20222022Призова Н.С., Болотина Л.В., Корниецкая А.Л.Prizova N.S., Bolotina L.V., Kornietskaya A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6929

Метастатическое поражение головного мозга (ГМ) ассоциируется с неблагоприятным течением заболевания и значимо влияет на качество и продолжительность жизни пациентов с раком молочной железы (РМЖ), а сложности в терапии обусловлены низкой способностью большинства лекарственных препаратов к преодолению гематоэнцефалического барьера.

Гормонопозитивный НЕР2-негативный РМЖ в ряде случаев обладает торпидным течением по сравнению с другими подтипами и чаще других встречается в популяции. Достигнутый в последние годы прорыв в лечении гормонопозитивного HER2neu-негативного метастатического РМЖ (мРМЖ) напрямую связан с появлением и широким применением в клинической практике ингибиторов CDK4/6, что достоверно улучшило не только выживаемость без прогрессирования (ВБП), но и общую выживаемость (ОВ), в т. ч. и у пациентов с метастатическим поражением головного мозга. В статье представлены результаты III фазы крупных рандомизированных исследований (MONALEESA-2, MONALEESA-3, MONALEESA-7 и Compleement-1), доказывающих эффективность терапии рибоциклибом в сочетании с эндокринными партнерами и обсуждается клиническое наблюдение пациентки с гормонопозитивным HER2-негативным РМЖ с метастатическим поражением ГМ, печени и костей при применении данной терапии.

Brain metastases (BM) are associated with poor prognosis, short overall survival, and severely compromised quality of life in patients with advanced breast cancer (BC). BM create therapeutic challenges in BC due to the difficulty for the majority of drugs to cross the blood-brain barrier. Hormone-positive HER2-negative breast cancer usually progresses slowly compared to other subtypes and it is the most common subtype among patients with BC. The cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors have rapidly transformed breast cancer treatment landscape within past few years. Integrating CDK4/6 inhibitors in clinical practice significantly improved both progression-free and overall survival in all patient population, including patients with BM. In this article we summarize the results of phase III randomized controlled trials (MONALEESA-2, MONALEESA-3, MONALEESA-7, and Completion-1), suggesting the efficacy of the combination of ribociclib with various endocrine therapies, and present a clinical case discussion of a patient with advanced hormone-positive HER2-negative BC with brain, hepatic and bone metastases treated with combined targeted and endocrine therapy.

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The authors declare that there are no conflicts of interest present.