Abstract
ABSTRACT Background The management of metastatic breast cancer has moved to tailored treatment following the discovery of different tumor types by genotyping. Triple negative breast cancer was proven to be a chemosensitive disease where platinum salts were also effective besides anthracyclines and taxanes. The experience with cisplatin combination chemotherapy in a more general population is however, lacking. Patients and methods We reviewed the files of 12 patients who presented with liver metastases (9 patients, two of which had synchronous brain metastases) and locally advanced breast cancer (3 patients). All biopsies showed triple negative breast cancer on immunohistochemistry. Median age was 70y (40-76y). They were treated with an ambulatory cisplatin and gemcitabin regimen, consisting of gemcitabin 1000 mg/m2 on day 1 + 8 and cisplatin 35 mg/m2 on day 2 + 9, q3w. Two patients died two weeks after starting chemotherapy. Response rates were 66% (2 CR, 6 PR). Time to progression was 5 months (1-14 months) median survival was 7 months (1-24 months). Three patients had subsequent mastectomy, in one case there was down staging to pT0, in the two other cases there was down staging to pT3N1 disease. Breast surgery was performed after a median of two weeks after chemotherapy. Conclusion Cisplatin-gemcitabine combination is feasible on an outpatient basis and has similar efficacy as reported in more selected patients. In patients presenting with liver metastasis this regimen was effective, even in patients presenting with severe jaundice. Two patients with synchronous brain metastases also had a partial response on cerebral imaging. In line with prior observations our patient population was older than the initial study population nevertheless these data confirm similar efficacy. Disclosure All authors have declared no conflicts of interest.
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