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Combined Antiangiogenic and Mammalian Target of Rapamycin Inhibitor Targeted Therapy in Metaplastic Breast Cancer Harboring a PIK3CA Mutation.

Agarwal R, Koenig K, Rohren E, Subbiah V - J Breast Cancer (2014)

Bottom Line: Partial remission was achieved.In this report, the scientific rationale underlying the activity of this combination was explored.In conclusion, patients may benefit from being offered molecular profiling early during the course of the disease to receive a therapy guided accordingly.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology and Oncology, University of Cincinnati College of Medicine, Cincinnati, USA.

ABSTRACT
Metaplastic breast cancer (MpBC) is an extremely rare breast cancer subtype, characterized by a heterogeneous phenotype. MpBC aggressive biology is attributed to its stem cell-like characteristics. Since these tumors are largely chemoresistant, novel targeted therapies should be explored. Herein, we report the clinical course of a 59-year-old African American woman with MpBC with a PIK3CA mutation in codon 545, exon 10 (GAG to AAG; p.Glu545Lys) and a TP53 mutation in codon 286, exon 8 (GAA to AAA; p.Glu286Lys). The same mutations were observed in the primary and secondary sites. The patient was treated with a molecularly matched therapy using a combined antiangiogenic and mammalian target of rapamycin kinase inhibitor strategy that included liposomal doxorubicin, bevacizumab, and temsirolimus. Partial remission was achieved. In this report, the scientific rationale underlying the activity of this combination was explored. In conclusion, patients may benefit from being offered molecular profiling early during the course of the disease to receive a therapy guided accordingly.

No MeSH data available.


Related in: MedlinePlus

Pretreatment fluorodeoxyglucose positron emission tomography/computed tomography of the patient showing multiple hypermetabolic pulmonary metastasis and hypermetabolic adenopathy in the thorax.
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Figure 1: Pretreatment fluorodeoxyglucose positron emission tomography/computed tomography of the patient showing multiple hypermetabolic pulmonary metastasis and hypermetabolic adenopathy in the thorax.

Mentions: The surgical pathological report indicated an invasive matrix-producing (metaplastic) carcinoma with patchy necrosis and 10% ER positivity, PR and HER2/neu negative, and stage pT2 N1 with 2 of 25 axillary lymph nodes presenting metastatic carcinoma. After radiation, the patient started a course of anastrozole, which was later switched to exemestane due to arthralgia. A year after surgery, the patient presented with pulmonary metastases and metastatic lymph nodes in the mediastinum and left internal mammary region (Figure 1).


Combined Antiangiogenic and Mammalian Target of Rapamycin Inhibitor Targeted Therapy in Metaplastic Breast Cancer Harboring a PIK3CA Mutation.

Agarwal R, Koenig K, Rohren E, Subbiah V - J Breast Cancer (2014)

Pretreatment fluorodeoxyglucose positron emission tomography/computed tomography of the patient showing multiple hypermetabolic pulmonary metastasis and hypermetabolic adenopathy in the thorax.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197360&req=5

Figure 1: Pretreatment fluorodeoxyglucose positron emission tomography/computed tomography of the patient showing multiple hypermetabolic pulmonary metastasis and hypermetabolic adenopathy in the thorax.
Mentions: The surgical pathological report indicated an invasive matrix-producing (metaplastic) carcinoma with patchy necrosis and 10% ER positivity, PR and HER2/neu negative, and stage pT2 N1 with 2 of 25 axillary lymph nodes presenting metastatic carcinoma. After radiation, the patient started a course of anastrozole, which was later switched to exemestane due to arthralgia. A year after surgery, the patient presented with pulmonary metastases and metastatic lymph nodes in the mediastinum and left internal mammary region (Figure 1).

Bottom Line: Partial remission was achieved.In this report, the scientific rationale underlying the activity of this combination was explored.In conclusion, patients may benefit from being offered molecular profiling early during the course of the disease to receive a therapy guided accordingly.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology and Oncology, University of Cincinnati College of Medicine, Cincinnati, USA.

ABSTRACT
Metaplastic breast cancer (MpBC) is an extremely rare breast cancer subtype, characterized by a heterogeneous phenotype. MpBC aggressive biology is attributed to its stem cell-like characteristics. Since these tumors are largely chemoresistant, novel targeted therapies should be explored. Herein, we report the clinical course of a 59-year-old African American woman with MpBC with a PIK3CA mutation in codon 545, exon 10 (GAG to AAG; p.Glu545Lys) and a TP53 mutation in codon 286, exon 8 (GAA to AAA; p.Glu286Lys). The same mutations were observed in the primary and secondary sites. The patient was treated with a molecularly matched therapy using a combined antiangiogenic and mammalian target of rapamycin kinase inhibitor strategy that included liposomal doxorubicin, bevacizumab, and temsirolimus. Partial remission was achieved. In this report, the scientific rationale underlying the activity of this combination was explored. In conclusion, patients may benefit from being offered molecular profiling early during the course of the disease to receive a therapy guided accordingly.

No MeSH data available.


Related in: MedlinePlus