Heceptin injected thru blood brain barrier

[1rarebird]

This patient apparently was not harmed but helped by this procedure. I wonder if it is being used elsewhere other than this one reported case.---bird



Breast Cancer Res Treat. 2011 Mar 3. [Epub ahead of print]
Complete response in HER2+ leptomeningeal carcinomatosis from breast cancer with intrathecal trastuzumab.

Oliveira M, Braga S, Passos-Coelho JL, Fonseca R, Oliveira J.
Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto, 1099-023, Lisbon, Portugal, mafalda.moliveira@gmail.com.
Abstract

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 (LC) 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 25 mg 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 LC 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.

[Laurel]

Wow! And at death there still was no sign of the brain mets! That's incredible. Wonder why more of this is not done? Too early?

[1rarebird]

The brain is such a fragile environment that I suppose injection of fluids into that realm is a very risky proposition. But the researchers recognize the potential of this direct intervention of Herceptin into the brain has such potential for positive results that they recommend follow up studies to determine the best way to proceed. I wonder if this could lead to TDM-1 being used in similar fashion.

But what I am struck with the most is the incredible bravery of the woman who agreed to go first and allow the unproven treatment to be used on her. I continue to be amazed and grateful for all those participating in clinical trials and studies which could hurt them on the chance that the results may end up benefiting us all.---bird

[shelleyd]

She survived an additonal 27 months. I want people to get better forever. That is why I only trust vaccines. Maybe nanotechnology can get particles small enough to work on brain mets. We need something that kills stem cells and filters out circulating tumor cells.

[Lani]

please see the following thread http://her2support.org/vbulletin/showthread.php?t=49110
already posted to see the difference between leptomeningeal carcinomatosis and brain mets