title: [Two cases treated with trastuzumab as primary chemotherapy].
abstract: We report two cases treated with primary chemotherapy containing trastuzumab with a review of some important papers. The first patient was a 43-year-old female. A 33-mm left breast invasive ductal carcinoma (ER (-), PgR (-), HER2 3+(IHC) ) with several lymph node metastases in the Ax, Ic and Sc was found. After primary chemotherapy with 6 courses of EC and 4 courses of weekly paclitaxel + trastuzumab, the efficacy for the local tumor was judged as PR. However, brain metastases appeared, so the operation was canceled. Brain metastases were then treated by gamma-knife three times, but systemic chemotherapy was not administered. Eight months later, carcinomatous meningitis appeared. Intrathecal chemotherapy with MTX+Ara-C was started, but the patient died after 20 months from the beginning of the treatment. Local efficacy was judged as CR. The second patient was a 41-year-old female. A 39-mm right breast invasive ductal carcinoma (ER (-), PgR (-), HER2 3+(IHC) ) with two lymph node metastases in the Ax was found. After primary chemotherapy with 6 courses of FEC and 4 courses of weekly paclitaxel + trastuzumab, the efficacy was judged as PR. The operation was scheduled, but he patient wished to continue chemotherapy for cosmetic reasons. Later, because of mild tumor regrowth, we used 2 courses of vinorelbine in combination with trastuzumab. The tumor grew more, so Bp + Ax was done. The woman is alive at this writing with no recurrence.
authors.affiliation: Dept. of Frontier Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Murakami
authors.forename: Haruhito
authors.initials: H
authors.lastname: Sakata
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Miyazawa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsushita
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Akutsu
authors.forename: Takanori
authors.initials: T
authors.lastname: Nishimori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoneyama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Usui
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kano
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy*; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D000068878:Trastuzumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D000068878:Trastuzumab; D017239:Paclitaxel