Long Huei, Hu Chi-Tan, Prijatelj Vesna, Weng Ching-Feng
Department of Life Science and Institute of Biotechnology, National Dong Hwa University.
Research Centre for Hepatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation.
Medicine (Baltimore). 2020 Jul 2;99(27):e20808. doi: 10.1097/MD.0000000000020808.
Palbociclib (PAL) is a first-in-class selective inhibitor of the cyclin-dependent kinases 4 (CDK4) and CDK6 and is indicated for the treatment of hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) in combination with fulvestrant (FUL) in postmenopausal women. Antrodia cinnamomea (AC), a well-known Chinese folk medicine in Taiwan, possesses numerous biological capabilities, most notably an anti-tumor effect. However, the clinical use of AC as complementary medicine combined with adjuvant therapy is unexplored. In this case report, we evaluated AC combined with PAL plus FUL to reduce the tumor burden in an MBC patient.
A Slovenian woman diagnosed with relapsed bone metastases of breast cancer (BC) was unable to undergo surgery and refused radiation therapy due to fear of side effects; she also feared the side effects of adjuvants. However, she was eager to live with a high quality of life.
Stage IV, HR-positive/HER2-negative BC with relapse of bone metastases.
After diagnosis of relapse of bone metastases, she received adjuvant with PAL plus FUL. Additionally, she chose to take AC orally (10 g/d).
The pain was mostly relieved, and the side effects of adjuvant therapy reduced. Magnetic resonance imaging revealed reduction of tumor size at the fifth month of adjuvant therapy plus AC. After 14 months of adjuvant therapy plus AC, the tumors at the thoracic vertebrae T1 and T3 were found to have shrunk from 35.2 and 12.0 mm to 28.1 and 9.9 mm, respectively. Remarkably, no further metastases were observed.
According to the circulating tumor cells (CTCs) test data, AC had better anti-tumor efficacy on active tumor cells than PAL plus FUL. Thus, AC could be an effective complementary medicine for adjuvant therapy in patients with HR-positive/HER2-negative MBC. Interestingly, continued elevation of carcinoma antigen 15-3 and lactate dehydrogenase levels but decreasing levels of alkaline phosphatase were observed, which may be indicative of the potent efficacy of treatment resulting in massive tumor cell death. The CTCs test may be a sensitive approach to monitor the progression of BC and subsequently evaluate the efficiency of therapy.
帕博西尼（PAL）是首个选择性细胞周期蛋白依赖性激酶4（CDK4）和CDK6抑制剂，适用于联合氟维司群（FUL）治疗绝经后女性激素受体（HR）阳性/人表皮生长因子受体2（HER2）阴性转移性乳腺癌（MBC）。台湾一种著名的中国民间药物樟芝（AC）具有多种生物学功能，最显著的是抗肿瘤作用。然而，AC作为辅助治疗的补充药物的临床应用尚未得到探索。在本病例报告中，我们评估了AC联合PAL加FUL以减轻一名MBC患者的肿瘤负担。
一名被诊断为乳腺癌（BC）复发骨转移的斯洛文尼亚女性因担心副作用而无法接受手术且拒绝放疗；她也害怕辅助药物的副作用。然而，她渴望高质量地生活。
IV期，HR阳性/HER2阴性BC伴骨转移复发。
在诊断为骨转移复发后，她接受了PAL加FUL的辅助治疗。此外，她选择口服AC（10克/天）。
疼痛大部分缓解，辅助治疗的副作用减轻。磁共振成像显示在辅助治疗加AC的第五个月肿瘤大小减小。在辅助治疗加AC 14个月后，发现胸1和胸3椎体的肿瘤分别从35.2毫米和12.0毫米缩小至28.1毫米和9.9毫米。值得注意的是，未观察到进一步的转移。
根据循环肿瘤细胞（CTC）检测数据，AC对活跃肿瘤细胞的抗肿瘤疗效优于PAL加FUL。因此，AC可能是HR阳性/HER2阴性MBC患者辅助治疗的有效补充药物。有趣的是，观察到癌抗原1-3和乳酸脱氢酶水平持续升高，但碱性磷酸酶水平下降，这可能表明治疗效果显著导致大量肿瘤细胞死亡。CTC检测可能是监测BC进展并随后评估治疗效果的一种敏感方法。
