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Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases
Brain metastases (BMs) represent a major issue in clinical practice and are associated with a significant worsening of patient’s quality of life and, often, a dismal prognosis. Breast cancer (BC) is the second most common solid malignancy that metastasizes to the central nervous system. Incidence of...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322880/ https://www.ncbi.nlm.nih.gov/pubmed/25678799 http://dx.doi.org/10.2147/OTT.S74110 |
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author | Ricciardi, Giuseppina Rosaria Rita Russo, Alessandro Franchina, Tindara Ferraro, Giuseppa Adamo, Vincenzo |
author_facet | Ricciardi, Giuseppina Rosaria Rita Russo, Alessandro Franchina, Tindara Ferraro, Giuseppa Adamo, Vincenzo |
author_sort | Ricciardi, Giuseppina Rosaria Rita |
collection | PubMed |
description | Brain metastases (BMs) represent a major issue in clinical practice and are associated with a significant worsening of patient’s quality of life and, often, a dismal prognosis. Breast cancer (BC) is the second most common solid malignancy that metastasizes to the central nervous system. Incidence of BM varies according to the tumor subtype, with higher rates in patients with epidermal growth factor receptor 2 (HER2) overexpression and in triple negative breast cancers. The incidence of BM in HER2-positive BC patients has increased as a consequence of the success of trastuzumab-based therapy. BM represents an emerging unmet medical need and no specific treatment options exist because, until recently, nearly all randomized clinical trials in metastatic breast cancer (MBC) excluded such patients. Therefore, novel approaches in this setting are eagerly awaited. Herein, we report a lengthy progression-free survival with the combination trastuzumab/nanoparticle albumin-bound (nab)-paclitaxel in a heavily pretreated HER2-positive BC patient with BM. The long-term disease stabilization reported in the present case (>13 months) is of note for several reasons. First, the nab-paclitaxel plus trastuzumab combination, despite several previous lines of treatment, some of which were associated with known activity on BM, was the first systemic therapy not associated with central nervous system recurrence, avoiding recourse to additional locoregional treatments. Moreover, this combination was associated with long extracranial stabilization with minimal toxicity. The remarkably lengthy progression-free survival reported in our case with the nab-paclitaxel plus trastuzumab combination further confirms the efficacy and the favorable toxicity profile of this promising schedule that showed intriguing results in two phase II studies in first-line MBC and suggests a possible activity on BM. In conclusion, weekly nab-paclitaxel plus trastuzumab may represent a valuable option in the treatment of HER2-positive MBC with BM after radiotherapy and is effective and associated with a good toxicity profile, even in heavily pretreated patients. |
format | Online Article Text |
id | pubmed-4322880 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-43228802015-02-12 Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases Ricciardi, Giuseppina Rosaria Rita Russo, Alessandro Franchina, Tindara Ferraro, Giuseppa Adamo, Vincenzo Onco Targets Ther Case Report Brain metastases (BMs) represent a major issue in clinical practice and are associated with a significant worsening of patient’s quality of life and, often, a dismal prognosis. Breast cancer (BC) is the second most common solid malignancy that metastasizes to the central nervous system. Incidence of BM varies according to the tumor subtype, with higher rates in patients with epidermal growth factor receptor 2 (HER2) overexpression and in triple negative breast cancers. The incidence of BM in HER2-positive BC patients has increased as a consequence of the success of trastuzumab-based therapy. BM represents an emerging unmet medical need and no specific treatment options exist because, until recently, nearly all randomized clinical trials in metastatic breast cancer (MBC) excluded such patients. Therefore, novel approaches in this setting are eagerly awaited. Herein, we report a lengthy progression-free survival with the combination trastuzumab/nanoparticle albumin-bound (nab)-paclitaxel in a heavily pretreated HER2-positive BC patient with BM. The long-term disease stabilization reported in the present case (>13 months) is of note for several reasons. First, the nab-paclitaxel plus trastuzumab combination, despite several previous lines of treatment, some of which were associated with known activity on BM, was the first systemic therapy not associated with central nervous system recurrence, avoiding recourse to additional locoregional treatments. Moreover, this combination was associated with long extracranial stabilization with minimal toxicity. The remarkably lengthy progression-free survival reported in our case with the nab-paclitaxel plus trastuzumab combination further confirms the efficacy and the favorable toxicity profile of this promising schedule that showed intriguing results in two phase II studies in first-line MBC and suggests a possible activity on BM. In conclusion, weekly nab-paclitaxel plus trastuzumab may represent a valuable option in the treatment of HER2-positive MBC with BM after radiotherapy and is effective and associated with a good toxicity profile, even in heavily pretreated patients. Dove Medical Press 2015-02-02 /pmc/articles/PMC4322880/ /pubmed/25678799 http://dx.doi.org/10.2147/OTT.S74110 Text en © 2015 Ricciardi et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Case Report Ricciardi, Giuseppina Rosaria Rita Russo, Alessandro Franchina, Tindara Ferraro, Giuseppa Adamo, Vincenzo Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title | Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title_full | Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title_fullStr | Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title_full_unstemmed | Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title_short | Efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated HER2-positive breast cancer patient with brain metastases |
title_sort | efficacy of nab-paclitaxel plus trastuzumab in a long-surviving heavily pretreated her2-positive breast cancer patient with brain metastases |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322880/ https://www.ncbi.nlm.nih.gov/pubmed/25678799 http://dx.doi.org/10.2147/OTT.S74110 |
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