Amin Adina, Sirikanjanapong Sasis, Kalsi Amardeep, Taiwo Evelyn
Department of Internal Medicine, New York-Presbyterian Brooklyn Methodist Hospital Brooklyn, Brooklyn, NY, USA.
Department of Pathology and Laboratory Medicine, Weill Cornell Medicine New York, New York, NY, USA.
Case Rep Oncol. 2024 Oct 15;17(1):1157-1165. doi: 10.1159/000541314. eCollection 2024 Jan-Dec.
Inflammatory breast cancer is a rare and aggressive subtype, with high breast cancer mortality. Compared to noninflammatory breast cancer, even after treatment and response to standard-of-care breast cancer chemotherapy, it has a high propensity for lymph node involvement, high rates of distant metastasis, and shorter survival. The immune checkpoint inhibitor, pembrolizumab, in combination with chemotherapy is now approved for early triple negative breast cancer (TNBC) and for advanced disease if positive for the programmed cell death ligand 1 protein (PD-L1). The response and survival of metastatic inflammatory TNBC to immunotherapy is largely unreported and we present a case of a young woman with metastatic triple negative inflammatory breast cancer, treated with pembrolizumab, carboplatin, and paclitaxel.
A 46-year-old female presented with de novo metastatic inflammatory TNBC with metastasis to lymph nodes, lung, and bones. She was treated with pembrolizumab, carboplatin, and paclitaxel leading to rapid and complete radiographic response. The response was however short lived, and the patient presented with diffuse disease progression in the lungs with pleural effusions, causing death from respiratory distress.
Treatment for metastatic triple negative inflammatory breast cancer mirrors treatment of metastatic TNBC. In PD-L1 positive disease, treatment with chemotherapy and pembrolizumab is first line and in this case led to robust but short-lived response. Inflammatory breast cancer remains a poorly understood breast cancer subtype, and even in the presence of good treatment response, prognosis and survival remain poor. Further studies are warranted to better understand and treat the disease.
炎性乳腺癌是一种罕见且侵袭性强的亚型，乳腺癌死亡率高。与非炎性乳腺癌相比，即使在接受治疗并对标准护理的乳腺癌化疗有反应后，它仍有很高的淋巴结受累倾向、远处转移率高且生存期短。免疫检查点抑制剂帕博利珠单抗与化疗联合目前已被批准用于早期三阴性乳腺癌（TNBC），对于晚期疾病，如果程序性细胞死亡配体1蛋白（PD-L1）呈阳性也可使用。转移性炎性TNBC对免疫治疗的反应和生存期在很大程度上尚未见报道，我们报告一例年轻女性转移性三阴性炎性乳腺癌患者，接受了帕博利珠单抗、卡铂和紫杉醇治疗。
一名46岁女性出现新发转移性炎性TNBC，伴有淋巴结、肺和骨转移。她接受了帕博利珠单抗、卡铂和紫杉醇治疗，影像学上迅速出现完全反应。然而，反应持续时间较短，患者出现肺部弥漫性疾病进展并伴有胸腔积液，最终因呼吸窘迫死亡。
转移性三阴性炎性乳腺癌的治疗与转移性TNBC的治疗相似。在PD-L1阳性疾病中，化疗和帕博利珠单抗联合治疗是一线治疗方法，在本病例中导致了强烈但短暂的反应。炎性乳腺癌仍然是一种了解甚少的乳腺癌亚型，即使有良好的治疗反应，预后和生存期仍然很差。有必要进行进一步研究以更好地了解和治疗该疾病。
