Cargando…

The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature

The efficacy and safety of the combination of endocrine therapy (ET) and CDK4/6 inhibitors for patients with hormone receptor (HR)-positive HER2-negative metastatic breast cancer (BC) presenting with visceral crisis or life-threatening conditions represent a challenge for daily clinical practice. In...

Descripción completa

Detalles Bibliográficos
Autores principales: Garufi, Giovanna, Carbognin, Luisa, Orlandi, Armando, Palazzo, Antonella, Tortora, Giampaolo, Bria, Emilio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529000/
https://www.ncbi.nlm.nih.gov/pubmed/34692469
http://dx.doi.org/10.3389/fonc.2021.651723
_version_ 1784586370881159168
author Garufi, Giovanna
Carbognin, Luisa
Orlandi, Armando
Palazzo, Antonella
Tortora, Giampaolo
Bria, Emilio
author_facet Garufi, Giovanna
Carbognin, Luisa
Orlandi, Armando
Palazzo, Antonella
Tortora, Giampaolo
Bria, Emilio
author_sort Garufi, Giovanna
collection PubMed
description The efficacy and safety of the combination of endocrine therapy (ET) and CDK4/6 inhibitors for patients with hormone receptor (HR)-positive HER2-negative metastatic breast cancer (BC) presenting with visceral crisis or life-threatening conditions represent a challenge for daily clinical practice. Indeed, the peculiarity of this clinical presentation (signs and symptoms of rapidly progressive disease) does not allow to include such patients in a trial aiming for drug approval. On the basis of the scientific evidence available so far, chemotherapy represents the standard of care according to guidelines, on the basis of the more rapid activity in comparison with ET alone. Besides, the combination of ET and CDK4/6 inhibitors have demonstrated in clinical trials to have clinically impactful activity in a short time, thus suggesting a potential role in advanced tumors that require rapid response. Herein, we report the clinical history of a young woman with HR-positive HER2-negative metastatic BC and a pancytopenia due to carcinomatosis of the bone marrow receiving letrozole and leuprorelin plus the CDK4/6 inhibitor palbociclib, who significantly derived clinical benefit from treatment. Considering that these peculiar cases are excluded from clinical trials, the estimation of the magnitude of the benefit of the newer ET combination may potentially represent a practical question for large case series and real-world studies.
format Online
Article
Text
id pubmed-8529000
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-85290002021-10-22 The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature Garufi, Giovanna Carbognin, Luisa Orlandi, Armando Palazzo, Antonella Tortora, Giampaolo Bria, Emilio Front Oncol Oncology The efficacy and safety of the combination of endocrine therapy (ET) and CDK4/6 inhibitors for patients with hormone receptor (HR)-positive HER2-negative metastatic breast cancer (BC) presenting with visceral crisis or life-threatening conditions represent a challenge for daily clinical practice. Indeed, the peculiarity of this clinical presentation (signs and symptoms of rapidly progressive disease) does not allow to include such patients in a trial aiming for drug approval. On the basis of the scientific evidence available so far, chemotherapy represents the standard of care according to guidelines, on the basis of the more rapid activity in comparison with ET alone. Besides, the combination of ET and CDK4/6 inhibitors have demonstrated in clinical trials to have clinically impactful activity in a short time, thus suggesting a potential role in advanced tumors that require rapid response. Herein, we report the clinical history of a young woman with HR-positive HER2-negative metastatic BC and a pancytopenia due to carcinomatosis of the bone marrow receiving letrozole and leuprorelin plus the CDK4/6 inhibitor palbociclib, who significantly derived clinical benefit from treatment. Considering that these peculiar cases are excluded from clinical trials, the estimation of the magnitude of the benefit of the newer ET combination may potentially represent a practical question for large case series and real-world studies. Frontiers Media S.A. 2021-10-07 /pmc/articles/PMC8529000/ /pubmed/34692469 http://dx.doi.org/10.3389/fonc.2021.651723 Text en Copyright © 2021 Garufi, Carbognin, Orlandi, Palazzo, Tortora and Bria https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Garufi, Giovanna
Carbognin, Luisa
Orlandi, Armando
Palazzo, Antonella
Tortora, Giampaolo
Bria, Emilio
The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title_full The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title_fullStr The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title_full_unstemmed The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title_short The Therapeutic Challenge of Disseminated Bone Marrow Metastasis From HR-Positive HER2-Negative Breast Cancer: Case Report and Review of the Literature
title_sort therapeutic challenge of disseminated bone marrow metastasis from hr-positive her2-negative breast cancer: case report and review of the literature
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529000/
https://www.ncbi.nlm.nih.gov/pubmed/34692469
http://dx.doi.org/10.3389/fonc.2021.651723
work_keys_str_mv AT garufigiovanna thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT carbogninluisa thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT orlandiarmando thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT palazzoantonella thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT tortoragiampaolo thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT briaemilio thetherapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT garufigiovanna therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT carbogninluisa therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT orlandiarmando therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT palazzoantonella therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT tortoragiampaolo therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature
AT briaemilio therapeuticchallengeofdisseminatedbonemarrowmetastasisfromhrpositiveher2negativebreastcancercasereportandreviewoftheliterature