Liver Metastasis of a Triple-Negative Breast Cancer and Complete Remission for 5 Years After Treatment With Combined Bevacizumab/Paclitaxel/Carboplatin: Case Report and Review of the Literature.
Triple-negative breast cancer (TNBC) is aggressive, with high risk of visceral metastasis and death. A substantial proportion of patients with TNBC is associated with BRCA mutations, implying that these tumors are sensitive to DNA-damaging agents. We report successful treatment of a metastatic TNBC in a woman with a BRCA2 germline mutation using combined bevacizumab/paclitaxel/carboplatin (BPC) therapy. The patient was pregnant and had liver metastases, and a complete clinical response was sustained for approximately 5 years. Mastectomy was performed during the 29th week of pregnancy, and the baby was later delivered by caesarean section. Subsequently, multiple metastases in both liver lobes were detected using computed tomography and magnetic resonance imaging and the patient was treated with a BPC regimen, which led to complete disappearance of metastatic lesions in the liver. No additional treatment was provided, and after 5 years the patient consented to direct sequencing of BRCA2 and a 6781delG mutation was identified. At the most recent (5-year) follow-up, the patient was alive with good quality of life and no evidence of metastases.This finding suggests that BPC therapy might be considered a good therapeutic option for the treatment of metastatic TNBC in a woman with a BRCA2 germline mutation.
From the Division of Breast and Endocrine Surgery (Omori), Department of Surgery, Toho University School of Medicine, Tokyo, Japan (HO, SM, FS, TO, SK, YK, HK); Ohki Memorial Kikuchi Cancer Clinic for Women, Saitama, Japan (YK); Division of Hematology and Oncology, Toho University Medical Center, Tokyo, Japan (KN); Department of Radiology, Toho University School of Medicine, Tokyo, Japan (NS, MK); and Faculty of Nursing, Toho University, Tokyo, Japan (YM).
Hideaki
H
Ogata
Yoshihiro
Y
Kikuchi
Kazuhiko
K
Natori
Nobuyuki
N
Shiraga
Masahiro
M
Kobayashi
Shunsuke
S
Magoshi
Fumi
F
Saito
Tadatoshi
T
Osaku
Shinsaku
S
Kanazawa
Yorichika
Y
Kubota
Yoshie
Y
Murakami
Hironori
H
Kaneko
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D024682:BRCA2 Protein / Q000235:genetics; D000068258:Bevacizumab / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage*; D005260:Female; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D017239:Paclitaxel / Q000008:administration & dosage*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000235:genetics; D011256:Pregnancy Outcome; D012074:Remission Induction; D064726:Triple Negative Breast Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery
D024682:BRCA2 Protein; D000068258:Bevacizumab; D016190:Carboplatin; D017239:Paclitaxel