A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective

Chemotherapy is often difficult to treat human epidermal growth factor receptor 2 (HER2)-positive metastatic recurrent breast cancer in the elderly, and no standard treatment has been established at this point. We experienced a case in which trastuzumab (Tmab) + anastrozole (ANA) was ineffective (pr...

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Autores principales:	Tomohiro Shidahara, Shozo Ohsumi, Yuichiro Miyoshi, Mina Takahashi, Seiki Takashima, Kenjiro Aogi, Norihiro Teramoto
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	breast cancer t-dm1 elderly patient recurrence Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/674188a6bce94315b11aa61fbcff3e77
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spelling	oai:doaj.org-article:674188a6bce94315b11aa61fbcff3e772021-12-02T12:40:23ZA Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective1662-657510.1159/000520357https://doaj.org/article/674188a6bce94315b11aa61fbcff3e772021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/520357https://doaj.org/toc/1662-6575Chemotherapy is often difficult to treat human epidermal growth factor receptor 2 (HER2)-positive metastatic recurrent breast cancer in the elderly, and no standard treatment has been established at this point. We experienced a case in which trastuzumab (Tmab) + anastrozole (ANA) was ineffective (progressive disease; PD) in elderly HER2-positive breast cancer with postoperative multiple liver metastases, but T-DM1 was significantly effective (complete response; CR), and treatment could be continued safely. An 82-year-old woman was referred to our department with a right breast mass. A close examination revealed right breast cancer cT1bN0M0 cStage I, and total mastectomy and sentinel lymph node biopsy were performed. The postoperative pathological result was pT1bN0M0 pStage I (luminal HER2 type). The patient was elderly and had no adjuvant treatment after the operation. Approximately 2 years after the operation, multiple liver metastases were observed, and treatment with ANA and Tmab was started. Four months later, MRI showed that the number of multiple liver metastases increased. The patient was diagnosed with PD, and the anti-HER2 drug was changed from trastuzumab to trastuzumab emtansine (T-DM1). The dose was reduced due to vomiting (grade 3). Two months later, MRI showed that the multiple liver metastases shrank and became obscure after 5 months. After that, T-DM1 was continued, and the disease did not worsen. In elderly people with difficulty in administering chemotherapy, T-DM1 may have a safe and sufficient therapeutic effect by adjusting the dose and managing side effects appropriately.Tomohiro ShidaharaShozo OhsumiYuichiro MiyoshiMina TakahashiSeiki TakashimaKenjiro AogiNorihiro TeramotoKarger Publishersarticlebreast cancert-dm1elderly patientrecurrenceNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCase Reports in Oncology, Vol 14, Iss 3, Pp 1632-1637 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	breast cancer t-dm1 elderly patient recurrence Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	breast cancer t-dm1 elderly patient recurrence Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Tomohiro Shidahara Shozo Ohsumi Yuichiro Miyoshi Mina Takahashi Seiki Takashima Kenjiro Aogi Norihiro Teramoto A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
description	Chemotherapy is often difficult to treat human epidermal growth factor receptor 2 (HER2)-positive metastatic recurrent breast cancer in the elderly, and no standard treatment has been established at this point. We experienced a case in which trastuzumab (Tmab) + anastrozole (ANA) was ineffective (progressive disease; PD) in elderly HER2-positive breast cancer with postoperative multiple liver metastases, but T-DM1 was significantly effective (complete response; CR), and treatment could be continued safely. An 82-year-old woman was referred to our department with a right breast mass. A close examination revealed right breast cancer cT1bN0M0 cStage I, and total mastectomy and sentinel lymph node biopsy were performed. The postoperative pathological result was pT1bN0M0 pStage I (luminal HER2 type). The patient was elderly and had no adjuvant treatment after the operation. Approximately 2 years after the operation, multiple liver metastases were observed, and treatment with ANA and Tmab was started. Four months later, MRI showed that the number of multiple liver metastases increased. The patient was diagnosed with PD, and the anti-HER2 drug was changed from trastuzumab to trastuzumab emtansine (T-DM1). The dose was reduced due to vomiting (grade 3). Two months later, MRI showed that the multiple liver metastases shrank and became obscure after 5 months. After that, T-DM1 was continued, and the disease did not worsen. In elderly people with difficulty in administering chemotherapy, T-DM1 may have a safe and sufficient therapeutic effect by adjusting the dose and managing side effects appropriately.
format	article
author	Tomohiro Shidahara Shozo Ohsumi Yuichiro Miyoshi Mina Takahashi Seiki Takashima Kenjiro Aogi Norihiro Teramoto
author_facet	Tomohiro Shidahara Shozo Ohsumi Yuichiro Miyoshi Mina Takahashi Seiki Takashima Kenjiro Aogi Norihiro Teramoto
author_sort	Tomohiro Shidahara
title	A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
title_short	A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
title_full	A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
title_fullStr	A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
title_full_unstemmed	A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective
title_sort	case of multiple liver metastases after surgery in elderly her2-positive breast cancer in which anastrozole + trastuzumab was ineffective but t-dm1 was effective
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/674188a6bce94315b11aa61fbcff3e77
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A Case of Multiple Liver Metastases after Surgery in Elderly HER2-Positive Breast Cancer in Which Anastrozole + Trastuzumab Was Ineffective but T-DM1 Was Effective

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