title: Is the skin a sanctuary for breast cancer cells during treatment with anti-HER2 antibodies?
abstract: The occurrence of skin metastases is a common event in patients affected by advanced breast cancer, usually associated with systemic disease progression. Here we describe 2 cases of diffuse cutaneous metastases from HER2-overexpressing breast cancer occurring despite a dramatic response in liver and bone, respectively, during treatment with anti-HER2 antibodies Trastuzumab and Pertuzumab. We discuss the reasons for this discrepancy and suggest a possible implication of impaired immune response in the skin. Future research should provide strategies to overcome the induction of immune privilege in the skin in order to avoid discontinuation of effective treatments.
authors.affiliation: a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Graziano
authors.affiliation: b Medical Oncology Unit; "G. Bernabeo" Hospital ; Ortona , Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Scognamiglio
authors.affiliation: c Medical Oncology Unit; "SS. Annunziata" Hospital ; Chieti , Italy.
authors.forename: Marinella
authors.initials: M
authors.lastname: Zilli
authors.affiliation: c Medical Oncology Unit; "SS. Annunziata" Hospital ; Chieti , Italy.
authors.forename: Jamara
authors.initials: J
authors.lastname: Giampietro
authors.affiliation: d Division of Medical Oncology B; Regina Elena National Cancer Institute ; Rome , Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Vici
authors.affiliation: a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Natoli
authors.affiliation: a Department of Medical ; Oral and Biotechnological Sciences; University "G. D'Annunzio" ; Chieti , Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Grassadonia
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism; D012878:Skin Neoplasms / Q000175:diagnosis / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D000068878:Trastuzumab / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab
keywords: breast cancer; immune privilege; immune response; immune tolerance; pertuzumab; skin metastases; trastuzumab