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Efficacy of lapatinib monotherapy on occult breast cancer presenting with cutaneous metastases: A case report.

Noguchi E, Kamio T, Kamio H, Miura H, Tamaki M, Nishizawa M, Aoyama K, Oochi T, Kameoka S - Oncol Lett (2014)

Bottom Line: Breast ultrasonography was performed 10 months after the initial trastuzumab administration and the left axillary lymph node enlargement had reduced in size and severity.As determined by the result of a skin biopsy of this area, the patient was diagnosed with occult breast cancer with cutaneous metastases.At present (34 months following lapatinib monotherapy initiation) no new lesions or severe side-effects have been observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery II, Tokyo Women's Medical University, Tokyo 162-8666, Japan.

ABSTRACT
The case of a 72-year-old female who identified a lymph node enlargement in the left axilla is reported in the present study. A lymph node biopsy revealed a metastatic adenocarcinoma of the axillary lymph node. Following various assessments, the patient was diagnosed with occult breast cancer and lymph node metastases, for which treatment was initiated. Trastuzumab monotherapy was administered as the patient was elderly, positive for the hepatitis B virus and exhibited the following immunostaining/immunohistochemical analysis results: Estrogen receptor (ER) negative (-), progesterone receptor (PgR) negative (-) and human epidermal growth factor receptor 2 (HER2) positive (3+). Breast ultrasonography was performed 10 months after the initial trastuzumab administration and the left axillary lymph node enlargement had reduced in size and severity. However, a skin rash (erythema) was observed encompassing the left breast and extending into the axilla. As determined by the result of a skin biopsy of this area, the patient was diagnosed with occult breast cancer with cutaneous metastases. The immunohistochemical analysis results obtained from the skin biopsy were similar to those obtained from the lymph nodes: ER (-), PgR (-) and HER2 (3+). Therefore, the patient was switched from trastuzumab to lapatinib monotherapy. The erythema completely disappeared after two months of treatment. At present (34 months following lapatinib monotherapy initiation) no new lesions or severe side-effects have been observed.

No MeSH data available.


Related in: MedlinePlus

TBCRC 006 phase II trial. ER, estrogen receptor; pCR, complete pathological response. ypT0-isN0, no residual invasive cancer in the breast or axilla; ypT0-N0-3, no residual invasive cancer in the breast.
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f8-ol-08-06-2448: TBCRC 006 phase II trial. ER, estrogen receptor; pCR, complete pathological response. ypT0-isN0, no residual invasive cancer in the breast or axilla; ypT0-N0-3, no residual invasive cancer in the breast.

Mentions: The TBCRC 006 trial (18), a single-arm phase II study, is a clinical trial of neoadjuvant lapatinib and trastuzumab with hormonal therapy and without chemotherapy in patients with HER2-overexpressing breast cancer using only the two anti-HER2 agents [combined with hormonal therapy, in the case of the ER (+) subjects]. The complete pathological response rate for ER (−) (HER2-type) was high at 28% (Fig. 8) (18). In the present case, the treatment was switched to lapatinib when the patient demonstrated resistance to trastuzumab. Therefore, the results of the abovementioned clinical trial cannot be directly applied. However, the present results demonstrate that a type of breast cancer exists upon which anti-HER2 monotherapy exerts an effect. Pertuzumab, which is a HER dimerization inhibitor, has become available in Japan (19,20). Identifying biomarkers of this type of breast cancer, which exhibits a CR as a result of the administration of anti-HER2 agents only, may significantly alter the treatment strategies that are adopted for HER2-type breast cancer.


Efficacy of lapatinib monotherapy on occult breast cancer presenting with cutaneous metastases: A case report.

Noguchi E, Kamio T, Kamio H, Miura H, Tamaki M, Nishizawa M, Aoyama K, Oochi T, Kameoka S - Oncol Lett (2014)

TBCRC 006 phase II trial. ER, estrogen receptor; pCR, complete pathological response. ypT0-isN0, no residual invasive cancer in the breast or axilla; ypT0-N0-3, no residual invasive cancer in the breast.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214420&req=5

f8-ol-08-06-2448: TBCRC 006 phase II trial. ER, estrogen receptor; pCR, complete pathological response. ypT0-isN0, no residual invasive cancer in the breast or axilla; ypT0-N0-3, no residual invasive cancer in the breast.
Mentions: The TBCRC 006 trial (18), a single-arm phase II study, is a clinical trial of neoadjuvant lapatinib and trastuzumab with hormonal therapy and without chemotherapy in patients with HER2-overexpressing breast cancer using only the two anti-HER2 agents [combined with hormonal therapy, in the case of the ER (+) subjects]. The complete pathological response rate for ER (−) (HER2-type) was high at 28% (Fig. 8) (18). In the present case, the treatment was switched to lapatinib when the patient demonstrated resistance to trastuzumab. Therefore, the results of the abovementioned clinical trial cannot be directly applied. However, the present results demonstrate that a type of breast cancer exists upon which anti-HER2 monotherapy exerts an effect. Pertuzumab, which is a HER dimerization inhibitor, has become available in Japan (19,20). Identifying biomarkers of this type of breast cancer, which exhibits a CR as a result of the administration of anti-HER2 agents only, may significantly alter the treatment strategies that are adopted for HER2-type breast cancer.

Bottom Line: Breast ultrasonography was performed 10 months after the initial trastuzumab administration and the left axillary lymph node enlargement had reduced in size and severity.As determined by the result of a skin biopsy of this area, the patient was diagnosed with occult breast cancer with cutaneous metastases.At present (34 months following lapatinib monotherapy initiation) no new lesions or severe side-effects have been observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery II, Tokyo Women's Medical University, Tokyo 162-8666, Japan.

ABSTRACT
The case of a 72-year-old female who identified a lymph node enlargement in the left axilla is reported in the present study. A lymph node biopsy revealed a metastatic adenocarcinoma of the axillary lymph node. Following various assessments, the patient was diagnosed with occult breast cancer and lymph node metastases, for which treatment was initiated. Trastuzumab monotherapy was administered as the patient was elderly, positive for the hepatitis B virus and exhibited the following immunostaining/immunohistochemical analysis results: Estrogen receptor (ER) negative (-), progesterone receptor (PgR) negative (-) and human epidermal growth factor receptor 2 (HER2) positive (3+). Breast ultrasonography was performed 10 months after the initial trastuzumab administration and the left axillary lymph node enlargement had reduced in size and severity. However, a skin rash (erythema) was observed encompassing the left breast and extending into the axilla. As determined by the result of a skin biopsy of this area, the patient was diagnosed with occult breast cancer with cutaneous metastases. The immunohistochemical analysis results obtained from the skin biopsy were similar to those obtained from the lymph nodes: ER (-), PgR (-) and HER2 (3+). Therefore, the patient was switched from trastuzumab to lapatinib monotherapy. The erythema completely disappeared after two months of treatment. At present (34 months following lapatinib monotherapy initiation) no new lesions or severe side-effects have been observed.

No MeSH data available.


Related in: MedlinePlus