Ribociclib in patient with hormone-positive HER2-negative breast cancer with brain metastases: a case report

Abstract

Brain metastases (BM) are associated with poor prognosis, short overall survival, and severely compromised quality of life in patients with advanced breast cancer (BC). BM create therapeutic challenges in BC due to the difficulty for the majority of drugs to cross the blood-brain barrier. Hormone-positive HER2-negative breast cancer usually progresses slowly compared to other subtypes and it is the most common subtype among patients with BC. The cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors have rapidly transformed breast cancer treatment landscape within past few years. Integrating CDK4/6 inhibitors in clinical practice significantly improved both progression-free and overall survival in all patient population, including patients with BM. In this article we summarize the results of phase III randomized controlled trials (MONALEESA-2, MONALEESA-3, MONALEESA-7, and Completion-1), suggesting the efficacy of the combination of ribociclib with various endocrine therapies, and present a clinical case discussion of a patient with advanced hormone-positive HER2-negative BC with brain, hepatic and bone metastases treated with combined targeted and endocrine therapy.