Abstract
IntroductionThis case report and short review discusses how long trastuzumab should be continued in metastatic breast cancer, the safety issues in case of pregnancy and the risk of relapse with trastuzumab cessation.Case presentationWe present the case of a 34-year-old Caucasian woman with human epidermal growth factor receptor 2-positive metastatic breast cancer in the liver who achieved prolonged complete remission within six months of receiving trastuzumab (Herceptin) in combination with vinorelbine and gemcitabine. The patient remains in complete remission seven years later and continues to receive trastuzumab as maintenance therapy.ConclusionTrastuzumab-based therapies have greatly improved the survival rates of patients with human epidermal growth factor receptor 2- positive metastatic breast cancer. Despite such improvements, the safety of trastuzumab administration during pregnancy is yet to be defined.
Highlights
This case report and short review discusses how long trastuzumab should be continued in metastatic breast cancer, the safety issues in case of pregnancy and the risk of relapse with trastuzumab cessation.Case presentation: We present the case of a 34-year-old Caucasian woman with human epidermal growth factor receptor 2-positive metastatic breast cancer in the liver who achieved prolonged complete remission within six months of receiving trastuzumab (Herceptin) in combination with vinorelbine and gemcitabine
The development of trastuzumab (Herceptin), a humanized human epidermal growth factor receptor 2 (HER2) monoclonal antibody, has changed the natural history of HER2-positive breast cancer, providing superior survival benefits in combination or as monotherapy compared with nontrastuzumab-based therapy [1,2]
HER2-positive metastatic breast cancer (MBC) is an aggressive disease, and despite these advances, the majority of patients treated with trastuzumab-based regimens progress within one year, with only very few patients experiencing prolonged remission [3]
Summary
We predict that a number of patients (not reported) experience prolonged remission while receiving trastuzumab maintenance therapy. We speculate that the specific localization of breast cancer metastases may be a factor given that many of the cases reported to date are mainly associated with liver metastases [9,10]. Why this might be contributory needs additional investigation. Authors’ contributions JS collected and analyzed the data of the study and wrote the manuscript. AD collected the data of the patient, and NT conceived and designed the study and supervised the manuscript writing.
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