Yamashiro Hiroyasu, Morii Nao
Department of Breast Surgery, Tenri Hospital, Nara, Tenri 632-8552, Japan.
World J Clin Cases. 2023 Dec 16;11(35):8425-8430. doi: 10.12998/wjcc.v11.i35.8425.
This case report addresses the dearth of effective therapeutic interventions for central nervous system metastases in patients with HER2-negative breast cancer. It presents a unique case of a woman with estrogen receptor-positive, HER2-negative breast cancer who developed brain metastasis. The report highlights her initial favorable response to abemaciclib and letrozole therapy prior to the discontinuation due to drug-induced lung damage (DILD).
In this comprehensive case summary, we present the clinical course of a woman in her 60s, who 11 years following primary breast cancer surgery, was diagnosed with multiple brain metastases. As a third-line systemic therapy, she underwent treatment with abemaciclib and letrozole. This treatment approach yielded a near-partial response in her metastatic brain lesions. However, abemaciclib administration ceased due to the emergence of DILD, as confirmed by a computed tomography scan. The DILD improved after 1 mo of cessation. Despite ongoing therapeutic efforts, the patient's condition progressively deteriorated, ultimately resulting in death due to progression of the brain metastases.
This case underscores the challenge of managing adverse events in responsive brain metastasis patients, given the scarcity of therapeutic options.
本病例报告探讨了HER2阴性乳腺癌患者中枢神经系统转移缺乏有效治疗干预措施的问题。报告了一例雌激素受体阳性、HER2阴性乳腺癌女性发生脑转移的独特病例。该报告强调了她在因药物性肺损伤(DILD)停药前对阿贝西利和来曲唑治疗的初始良好反应。
在这份全面的病例摘要中,我们介绍了一位60多岁女性的临床病程,她在原发性乳腺癌手术11年后被诊断为多发脑转移。作为三线全身治疗,她接受了阿贝西利和来曲唑治疗。这种治疗方法使她的转移性脑病灶产生了近乎部分缓解。然而,经计算机断层扫描证实,由于出现DILD,阿贝西利停药。停药1个月后DILD有所改善。尽管持续进行治疗,但患者病情逐渐恶化,最终因脑转移进展而死亡。
鉴于治疗选择有限,该病例凸显了在有反应的脑转移患者中管理不良事件的挑战。