title: Complete and Sustained Response with a Doublet Chemotherapy Protocol in an 81-Year-Old Patient with Metastatic Breast Cancer.
abstract: Metastatic breast cancer (MBC) entails an overall 5-year survival of approximately 25%. The choice of therapy is influenced by expression of the HER2 gene and hormone receptors, by a disease-free interval, and by age. The use of paclitaxel combined with gemcitabine (doublet protocol) has shown efficacy as first-line treatment for MBC in either initial or maintenance therapy when compared to monotherapy with paclitaxel. There is evidence showing that the doublet protocol is a good alternative to maintenance therapy in women under 50 years old. Nevertheless, there is a lack of information concerning individuals above that age. We report the case of an 81-year-old patient presenting with recurrence of MBC, with lung and skin metastases both positive for hormone receptor and negative for HER2. We implemented a therapy based on the combination of gemcitabine and paclitaxel for 12 cycles, when complete response was achieved. Currently, 16 months after this achievement, the patient is receiving maintenance treatment under the doublet protocol, presenting acceptable parameters of toxicity since the beginning of treatment, which shows satisfactory tolerability and management of chemotherapy in an elderly patient. We suggest that the maintenance treatment protocol with a doublet might be an alternative with a satisfactory response in patients with MBC.
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Universidade do Estado do Pará, Belém, Brazil.
authors.forename: Taynah Cascaes
authors.initials: TC
authors.lastname: Puty
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Universidade Federal do Pará, Belém, Brazil.
authors.forename: Gabriel S A
authors.initials: GS
authors.lastname: Brito
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Universidade do Estado do Pará, Belém, Brazil.
authors.forename: Mariana S
authors.initials: MS
authors.lastname: Dias
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Universidade do Estado do Pará, Belém, Brazil.
authors.forename: Henrique C
authors.initials: HC
authors.lastname: Miranda
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Hospital Oncológica Brasil, Belém, Brazil.
authors.forename: Juliana R
authors.initials: JR
authors.lastname: Chaves
authors.affiliation: Hospital Porto Dias, Belém, Brazil.
authors.forename: Heryvelton L
authors.initials: HL
authors.lastname: Freitas
authors.affiliation: Oncológica Brazil - Education and Research, Belém, Brazil; Hospital Oncológica Brasil, Belém, Brazil.
authors.forename: Luís E W
authors.initials: LE
authors.lastname: Carvalho
keywords: Breast cancer; Complete response; Doublet chemotherapy; Old age