Okawa Yutaka, Sugiyama Katsuki, Aiba Keisuke, Hirano Akio, Uno Shinji, Hagino Takeshi, Kawase Kazumi, Shioya Hisashi, Yoshida Kazuhiko, Usui Noriko, Kobayashi Masao, Kobayashi Tadashi
Division of Hematology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishishinbashi Minato-ku, Tokyo 105-846l, Japan.
Breast Cancer. 2004;11(3):309-12. doi: 10.1007/BF02984555.
We present a case of adriamycin-and docetaxel-resistant inflammatory breast cancer (IBC) in which partial response was achieved with combination therapy using trastuzumab and paclitaxel. A 48-year old woman noticed a lump in her right breast. She was diagnosed with IBC and the disease was staged as T4d N1 M0, stage III B. The patient was started on neoadjuvant chemotherapy with adriamycin (50 mg/m2) and docetaxel (60 mg/m2) administered every three weeks. Six courses were performed and the response was evaluated as no change. After one month, contralateral breast swelling indicated bilateral IBC. Bilatera1 mastectomy using the Halsted method was performed. The immunohistochemical results of the Hercep Test was strongly positive (3+). After the mastectomy, right pleural effusion appeared, and cytological examination revealed the cells to be classV(adenocarcinoma). To treat the clinically advanced breast cancer, combination therapy with trastuzumab (initially 4 mg/kg followed by two or more cycles of 2 mg/kg) and paclitaxel (80 mg/m2) were given intravenously every week for eight cycles and then every two weeks thereafter. A total of 32 courses of therapy were performed, the pleural effusion completely disappeared and partial response was maintained for a duration of 482 days. The adverse reactions were mild, and it was possible for her to be treated as an outpatient with high quality of life. This report suggests that weekly combination therapy of trastuzumab and paclitaxel was useful for treatment of adriamycin-and docetaxel-resistant metastatic breast cancer.
我们报告了一例对阿霉素和多西他赛耐药的炎性乳腺癌（IBC），采用曲妥珠单抗和紫杉醇联合治疗取得了部分缓解。一名48岁女性发现右乳有一肿块。她被诊断为IBC，疾病分期为T4d N1 M0，ⅢB期。患者开始接受新辅助化疗，每三周给予阿霉素（50mg/m²）和多西他赛（60mg/m²）。共进行了六个疗程，评估反应为无变化。一个月后，对侧乳房肿胀提示双侧IBC。采用霍尔斯特德法进行了双侧乳房切除术。Hercep Test的免疫组化结果为强阳性（3+）。乳房切除术后，出现右侧胸腔积液，细胞学检查显示细胞为V类（腺癌）。为治疗临床晚期乳腺癌，给予曲妥珠单抗（初始剂量4mg/kg，随后两个或更多疗程为2mg/kg）和紫杉醇（80mg/m²）联合治疗，每周静脉注射一次，共八个疗程，之后每两周一次。总共进行了32个疗程的治疗，胸腔积液完全消失，部分缓解维持了482天。不良反应轻微，她能够作为门诊患者接受治疗，生活质量较高。本报告表明，曲妥珠单抗和紫杉醇每周联合治疗对阿霉素和多西他赛耐药的转移性乳腺癌治疗有效。
