Abstract
A 52-years old woman was diagnosed with an invasive left-sided ductal breast cancer, G3 – staged as T2N0M0; Estrogen (ER) 3+, Progesterone (PR) +, Human epidermal growth factor receptor 2 (HER 2) negative, Ki67-11%. She underwent a radical mastectomy, followed by adjuvant chemotherapy and hormone treatment with Tamoxifen. A year later she was diagnosed with a colorectal cancer-low grade, G1; histological results of adenocarcinoma - T3N1M1 with liver metastases. After a biopsy, which revealed that the metastases are coming from the breast (ER+/HER 2 (-) Breast cancer - (GATA (3+)), she was restaged as T3N1M0. The patient started treatment with Ribociclib 600mg/d + Letrozole 2,5mg/d with a partial response of the disease after three months of treatment. Due to G3 neutropenia, the dose was adjusted to 400 mg/d. Last restaging: October 2019 – complete response and a good quality of life. This case approves that the CDK (cyclin-dependent kinase) 4/6 inhibitors are able to manage visceral metastases and to provide long-term survival without worsening the quality of life. Her disease is successfully managed with CDK4/6 inhibitor together with hormonal therapy, which proves the effect of the CDK 4/6 inhibitors in treatment not only to breast cancer. Six months after there are no signs of relapse of the colon cancer. Despite the stage of the second cancer – T3N1M0, the patient did not undergo adjuvant treatment for the colon cancer.
Highlights
Breast cancer is the most common malignant disease among women – over 2,1 million women are affected annually according to the World Health Organization (WHO) [1]
CDK4/6 inhibitors combined with hormonal agents successfully treat hazard ratio (HR) (+)/HER2 (-) metastatic breast cancer
The MONALEESA-2 trial proves the combination between Ribociclib + Letrozole as a first line treatment for metastatic breast cancer (mBRCA), as well as PALOMA-2 respectively Palbociclib + Letrozole
Summary
Breast cancer is the most common malignant disease among women – over 2,1 million women are affected annually according to the World Health Organization (WHO) [1]. Breast cancer is a multifactor heterogeneous disease with epidemiologic significance for the society around the world. It affects most frequently the postmenopausal patients at the age 50-70y. The standard treatment of breast cancer is complexed It includes surgical methods, chemo- and radiotherapy, endocrine therapy for hormonal sensitive (HR+) tumors and targeted therapy for HER2-expressing tumors. In the last couple of years successfully started the combined therapy with CDK4/6 inhibitors together with endocrine therapy in hormonal sensitive metastatic breast cancer [3]. To the group of the CDK4/6 inhibitors belong Abemaciclib (Verzenio®), Palbociclib (Ibrance®) and Ribociclib (Kisqali®)
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