Intratekalna aplikacija trastuzumaba in rituksimaba Intrathecal administration of trastuzumab and rituximab

Abstract

Neoplastični meningitis je resen zaplet maligne bolezni. Kljub majhni incidenci njegova pogostost narašča, domnevno zaradi daljšega preživetja bolnikov in izboljšane diagnostike. Neoplastični meningitis se zdravi s sistemsko in intratekalno kemoterapijo ter z obsevanjem osrednjega živčevja. Trastuzumab in rituksimab sta monoklonski protitelesi, ki sta ob intravenskih aplikacijah pomembno izboljšali preživetje bolnikov z rakom dojk in Nehodgkinovim limfomom. Manj sta učinkoviti pri zdravljenju neoplastičnega meningitisa, saj zaradi velikosti ne prehajata krvno-možganske pregrade. Novejše raziskave preučujejo tudi možnost intratekalne aplikacije monoklonskih protiteles.

Abstract (Eng)

Neoplastic meningitis is a serious complication of malignant disease. In spite of low incidence, its frequency is increasing. This is believed to be due to better cancer patient survival and improved diagnostic procedures. Treatment of neoplastic meningitis usually consists of systemic and intrathecal therapy along with radiotherapy of central nervous system. Trastuzumab and rituximab are monoclonal antibodies that significantly improved the outcome of breast cancer and nonHodgkin lymphoma patients. While the two monoclonal antibodies are effective agents for their respective disease states, their efficacy is poor in the treatment of neoplastic meningitis as they are unable to cross the blood-brain barrier. This is a review of evidence for the potential use of intrathecal trastuzumab and rituximab.