Successful Treatment of Recurrent Triple-Negative Breast Cancer with Combination of Targeted Therapies
Stanislaw R. Burzynski, Alejandro Marquis, Eva Nagy-Kubove, Tomasz Janicki
.
DOI: 10.4236/jct.2011.23050   PDF    HTML   XML   8,321 Downloads   18,400 Views  

Abstract

We present an interesting case of a 56-year-old female diagnosed with invasive high-grade triple-negative breast cancer, who developed diffuse liver metastases following lumpectomy and combination chemotherapy with docetaxel, doxorubicin and cyclophosphamide, re-excision and radiation therapy. Restaging CT and PET scans revealed massive involvement of the liver. She was treated with a combination of gene targeted and cytotoxic chemotherapy including capecitabine, erlotinib, bevacizumab and phenylbutyrate. She tested weakly positive for HER-2 despite prior negative FISH, which prompted us to add trastuzumab to her regimen. Baseline CT revealed five liver tumors—the sum of the products of the two largest perpendicular diameters was 110 cm2. Follow-up CT after three months of treatment revealed 62% decrease in total tumor load. More than 50% decrease in tumor size persisted on two follow-up CT scans, confirming partial response. She developed progressive disease after 15 months of treatment. A group of 16 women, including this patient, diagnosed with triple negative breast cancer with distant metastases were treated by our team with a combination of gene targeted therapy and chemotherapy. Six percent of patients obtained partial response, 25% minor response, 31% stable disease, and 38% progressive disease. The median duration of treatment in patients who relapsed after the second-, third- and fourth- to seventh-lines of chemotherapy was 59 weeks, 22 weeks and 17 weeks, respectively. Comparison of results obtained with cytotoxic chemotherapy revealed that MDT in the second- and third-lines was only nine and four weeks, respectively. In conclusion, this case report indicates that it is possible to obtain durable objective response of recurrent TNBC with a combination of gene targeted agents.

Share and Cite:

S. Burzynski, A. Marquis, E. Nagy-Kubove and T. Janicki, "Successful Treatment of Recurrent Triple-Negative Breast Cancer with Combination of Targeted Therapies," Journal of Cancer Therapy, Vol. 2 No. 3, 2011, pp. 372-376. doi: 10.4236/jct.2011.23050.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] R. Dent, M. Trudeau, K. I. Pritchard, W. M. Hanna, H. K. Kahn, C. A. Sawka, L. A. Lickley, E. Rawlinson, P. Sun and S. A. Narod, “Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence,” Clinical Cancer Research, Vol. 13, No. 15, 2007, pp. 4429-4434. doi:10.1158/1078-0432.CCR-06-3045
[2] C. A. Livasy, “Triple-Negative Breast Carcinoma,” Surgical Pathology, Vol. 2, No. 2, 2009, pp. 247-261.
[3] B. P. Schneider, E. P. Winer, W. D. Foulkes, J. Garber, C. M. Perou, A. Richardson, G. W. Sledge and L. A. Carey, “Triple-Negative Breast Cancer: Risk Factors to Potential Targets,” Clinical Cancer Research, Vol. 14, No. 24, 2008, pp. 8010-8018. doi:10.1158/1078-0432.CCR-08-1208
[4] S. Verma, N. S. Wong, M. Trudeau, A. Joy, J. Mackey, G. Dranitsaris and M. Clemons, “Survival Differences Observed in Metastatic Breast Cancer Patients Treated with Capecitabine When Compared with Vinorelbine after Pretreatment with Anthracycline and Taxane,” American Journal of Clinical Oncology, Vol. 30, No. 3, 2007, pp. 297-302. doi:10.1097/01.coc.0000258125.97090.3f
[5] F. Kassam, K. Enright, R. Dent, G. Dranitsaris, J. Myers, C. Flynn, M. Fralick, R. Kumar and M. Clemons, “Survival Outcomes for Patients with Metastatic Triple-Negative Breast Cancer: Implications for Clinical Practice and Trial Design,” Clinical Breast Cancer, Vol. 9, No. 1, 2009, pp. 29-33. doi:10.3816/CBC.2009.n.005
[6] B. N. Rexer, R. Ghosh and C. L. Arteaga, “Inhibition of PI3K and MEK: It Is All about Combinations and Biomarkers,” Clinical Cancer Research, Vol. 15, No. 14, 2009, pp. 4518-4520. doi:10.1158/1078-0432.CCR-09-0872
[7] J. S. Ross, J. A. Fletcher, G. P. Linette, J. Stec, E. Clark, M. Ayers, W. F. Symmans, L. Pusztai and K. J. Bloom, “The Her-2/neu Gene and Protein in Breast Cancer 2003: Biomarker and Target of Therapy,” Oncologist, Vol. 8, No. 4, 2003, pp. 307-325. doi:10.1634/theoncologist.8-4-307
[8] A. K. Swayampakula, V. Gadiyaram and J. Abraham, “Serum Levels of HER2/neu, a Potential Alternative to Tissue Specimen Levels in the Management of Metastatic Breast Cancer: A Case Report and Literature Review,” Community Oncology, Vol. 6, No. 8, 2009, pp. 362-364.
[9] R. Iosifidou, G. Galaktidou , A. Ananiadis, N. Bladika, F. Patakiouta and A. Bousoulegas, “VEGF-A, VEGF-C, VEGF-R2, EGFR and HER2 in Serum Plus EGFR in Tissue of Patients with Triple-Negative Breast Cancer,” Breast Cancer Research, Vol. 11, 2009, p. 13.
[10] Y. Sawada, T. Fujii, H. Takahashi, G. Yokoyama, R. N. Matsubayashi, Y. Inoue, N. Uesugi, S. Momosaki, U. Toh and K. Shirouzu, “A Case of Triple Negative Chest Wall Recurrent Breast Cancer Treated with Capecitabine and Docetaxel Combination Therapy (XT Therapy),” Journal of Cancer Chemotherapy, Vol. 36, No. 5, 2009, pp. 815-817.
[11] G. Zhang, M. A. Park, C. Mitchell, H. Hamed, M. Rahmani, A. P. Martin, D. T. Curiel, A. Yacoub, M. Graf, R. Lee, J. D. Roberts, P. B. Fisher, S. Grant and P. Dent, “Vorinostat and Sorafenib Synergistically Kill Tumor Cells via FLIP Suppression and CD95 Activation,” Clinical Cancer Research, Vol. 14, No. 17, 2008, pp. 5385-5399. doi:10.1158/1078-0432.CCR-08-0469
[12] T. Samuel, W. Fiskus, C. Buser and K. Bhalla, “A Novel Combination Therapy with Histone Deacetylase Inhibitor and Aurora Kinase Inhibitor for ‘Triple Negative’ Breast Cancers,” Cancer Research, Vol. 69, No. 2, 2009, p. 401. doi:10.1158/0008-5472.SABCS-401

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.