Complete Response to Single-agent Palbociclib in Metastatic Breast Cancer: A Case Report.
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ABSTRACT:
SUBMITTER: Yeruva SLH
PROVIDER: S-EPMC5970002 | biostudies-literature | 2018 Jun
REPOSITORIES: biostudies-literature
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Complete Response to Single-agent Palbociclib in Metastatic Breast Cancer: A Case Report.
Yeruva Sri Lakshmi Hyndavi SLH Javadi Mehrbod Som MS Stearns Vered V
Clinical breast cancer 20171221 3
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Project description:IntroductionInflammatory breast cancer is a rare and aggressive subtype, with high breast cancer mortality. Compared to noninflammatory breast cancer, even after treatment and response to standard-of-care breast cancer chemotherapy, it has a high propensity for lymph node involvement, high rates of distant metastasis, and shorter survival. The immune checkpoint inhibitor, pembrolizumab, in combination with chemotherapy is now approved for early triple negative breast cancer (TNBC) and for advanced disease if positive for the programmed cell death ligand 1 protein (PD-L1). The response and survival of metastatic inflammatory TNBC to immunotherapy is largely unreported and we present a case of a young woman with metastatic triple negative inflammatory breast cancer, treated with pembrolizumab, carboplatin, and paclitaxel.Case presentationA 46-year-old female presented with de novo metastatic inflammatory TNBC with metastasis to lymph nodes, lung, and bones. She was treated with pembrolizumab, carboplatin, and paclitaxel leading to rapid and complete radiographic response. The response was however short lived, and the patient presented with diffuse disease progression in the lungs with pleural effusions, causing death from respiratory distress.ConclusionTreatment for metastatic triple negative inflammatory breast cancer mirrors treatment of metastatic TNBC. In PD-L1 positive disease, treatment with chemotherapy and pembrolizumab is first line and in this case led to robust but short-lived response. Inflammatory breast cancer remains a poorly understood breast cancer subtype, and even in the presence of good treatment response, prognosis and survival remain poor. Further studies are warranted to better understand and treat the disease.
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Project description:Breast cancer is considered a malignant tumor with the highest incidence among women and is prone to develop distant metastasis. Small intestinal metastasis of breast cancer, however, is relatively rare. This case report describes a 49-year-old Chinese female patient who presented with small intestinal obstruction and was diagnosed with lobular breast cancer with small intestinal and contralateral breast metastasis. Clinical manifestations, clinicopathological features and potential mechanisms of metastasis, along with diagnosis and treatment, are discussed with a review of the relevant literature. Although small intestinal metastasis is rare in breast cancer, we should keep high alert on the possibility of gastrointestinal metastasis when treating lobular breast cancer patients.
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Project description:Breast cancer is the most common cancer diagnosed in women. Each year, thousands die either because of disease progression or failure of treatment. Breast cancer is classified into different subtypes based on the molecular expression of estrogen receptor (ER), progesterone receptor, and/or human epidermal growth factor receptor 2 (HER2). These receptors represent important therapeutic targets either through monoclonal antibodies or through small-molecule inhibitors directed toward them. However, up to 40% of patients develop either a primary or a secondary resistance to the current treatments. Therefore, there is an urgent need for investigating new targets in order to overcome the resistance and/or enhance the current therapies. Cell cycle is altered in many human cancers, especially in breast cancer. Cyclin-dependent kinases (CDKs), especially CDK4 and CDK6, play a pivotal role in cell cycle progression that makes them potential targets for new promising therapies. CDK inhibition has shown strong antitumor activities, ranging from cytostatic antiproliferative effects to synergistic effects in combination with other antitumor drugs. In order to overcome the drawbacks of the first-generation CDK inhibitors, recently, new CDK inhibitors have emerged that are more selective to CDK4 and CDK6 such as palbociclib, which is the most advanced CDK4/6 inhibitor in trials. In preclinical studies, palbociclib has shown a very promising antitumor activity, especially against ERα+ breast cancer subtype. Palbociclib has gained world attention, and US the Food and Drug Administration has accelerated its approval for first-line treatment in combination with letrozole for the first-line systematic treatment of postmenopausal women with ERα+/HER2- locally advanced or metastatic breast cancer. In this review, we discuss the potential role of CDK inhibition in breast cancer treatment, and focus on palbociclib progress from preclinical studies to clinical trials with mentioning the most recent ongoing as well as planned Phase II and Phase III trials of palbociclib in advanced breast cancer.
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