Barchiesi Giacomo, Krasniqi Eriseld, Barba Maddalena, Giulia Marina Della, Pizzuti Laura, Massimiani Gioia, Ciliberto Gennaro, Vici Patrizia
IRCCS - Regina Elena Cancer Institute, Division of Medical Oncology 2.
IRCCS - Regina Elena Cancer Institute, Scientific Direction, Rome, Italy.
Medicine (Baltimore). 2019 Sep;98(37):e17135. doi: 10.1097/MD.0000000000017135.
In estrogen receptor-positive HER2-negative (ER+HER2-) metastatic breast cancer, chemotherapy should be offered only to patients who develop endocrine resistance or have a rapid disease progression. However, the correct sequence of chemotherapy administration is still debated.
We report the case of a 49-year-old woman with ER+ HER2- metastatic breast cancer who experienced an exceptionally long response to capecitabine administered as second-line therapy following a first-line anthracycline-based chemotherapy.
The patient was diagnosed with ER+ HER2- metastatic breast cancer with massive liver involvement and mediastinal lymph nodes metastasis.
This patient was treated with capecitabine 1000 mg/mq bid given intermittently for 14 days within a 21-day cycle as a second-line therapy following a rapid progression on letrozole treatment given as a maintenance therapy.
Our patient experienced a progression-free survival (PFS) >3 years with an exceptionally good quality of life (QoL).
In ER+HER2- metastatic breast cancer patients, capecitabine monochemotherapy in second line may be associated with a particularly satisfactory PFS and no impact in terms of QoL. Future studies focused on biomarkers with predictive ability may help select patients who represent the best candidates to this treatment.
在雌激素受体阳性、人表皮生长因子受体2阴性（ER+HER2-）的转移性乳腺癌中，仅应向出现内分泌耐药或疾病进展迅速的患者提供化疗。然而，化疗给药的正确顺序仍存在争议。
我们报告了一例49岁的ER+HER2-转移性乳腺癌女性患者，该患者在一线蒽环类化疗后接受卡培他滨作为二线治疗，获得了异常长的缓解期。
该患者被诊断为ER+HER2-转移性乳腺癌，伴有肝脏广泛受累和纵隔淋巴结转移。
该患者在接受来曲唑维持治疗后病情迅速进展，随后接受卡培他滨作为二线治疗，剂量为1000mg/m²，每日两次，在21天周期内间歇给药14天。
我们的患者无进展生存期（PFS）>3年，生活质量（QoL）极佳。
在ER+HER2-转移性乳腺癌患者中，二线使用卡培他滨单药化疗可能会带来特别令人满意的无进展生存期，且对生活质量无影响。未来针对具有预测能力的生物标志物的研究可能有助于选择最适合这种治疗的患者。
