Abstract
Background: Agent targeting HER-2 pathway plus chemotherapy has represented a major progress in the management of patients with breast cancer. However, the role of late-line treatment in heavily pretreated patients is still largely unclear. In the last decade, nab-paclitaxel has shown significant activity and good toxicity profile in metastatic breast cancer. Case Presentation: We report the case of a 76-year-old Caucasian woman with metastatic HER-2 positive ductal infiltrating breast carcinoma treated with a combination of weekly nab-paclitaxel and trastuzumab as fifth-line therapy. She had previously received first-line paclitaxel and trastuzumab, second-line vinorelbine and trastuzumab, third-line TDM1 and fourth-line oral capecitabine and lapatinib. Clinical and radiological staging showed progression at bone, skin and soft-tissue. The patient received weekly nab-paclitaxel plus trastuzumab. Massive objective response was clinically and PET documented which lasted 8 months. Tolerance to treatment was fairly good as well as cardiac safety. Conclusion: To the best of our knowledge, this is the first reported case of efficacy of nab-paclitaxel in combination with trastuzumab as fifth-line of treatment in a patient with metastatic HER-2 positive breast cancer.
Highlights
Case Presentation: We report the case of a 76-year-old Caucasian woman with metastatic HER-2 positive ductal infiltrating breast carcinoma treated with a combination of weekly nab-paclitaxel and trastuzumab as fifth-line therapy
The availability of anti-neoplastic agents targeting HER-2 has led to significant improvements in survival of these patients and to date sound clinical data support the use of trastuzumab and pertuzumab based combinations as well as TDM1 in this clinical setting [2] [3]
In this paper we report a case of a woman with metastatic breast carcinoma over-expressing HER-2 successfully treated with a combination of weekly nab-paclitaxel plus trastuzumab as fifthline therapy
Summary
The availability of anti-neoplastic agents targeting HER-2 has led to significant improvements in survival of these patients and to date sound clinical data support the use of trastuzumab and pertuzumab based combinations as well as TDM1 in this clinical setting [2] [3]. A significant proportion of patients progressing after third-line TDM1 is still in a good performance status and may deserve further treatment even if no clear indications are reported in major guidelines mainly because of lack of designed trials [4]. In this paper we report a case of a woman with metastatic breast carcinoma over-expressing HER-2 successfully treated with a combination of weekly nab-paclitaxel plus trastuzumab as fifthline therapy
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