title: [A Case of Recurrent Breast Cancer with Bone Metastasis Successfully Treated with Everolimus and Exemestane Therapy].
abstract: We report a case of a patient treated with everolimus and exemestane combination therapy for bone metastasis after breast surgery.The patient, a 58-year-old woman, consulted our department for back pain in October 2014.S he was diagnosed with left breast cancer when she was 41 years old.She had received Bt+Ax for left breast cancer and administered tamoxifen for 5 years.We decided on everolimus and exemestane combination therapy after observing an abnormal uptake in the 7th to 8th thoracic vertebrae on a PET-CT scan.The pain was controlled using oxycodone and fentanyl orally disintegrating tablet with zoledronic acid.After receiving treatment, the patient experienced pruritus and a Grade 2 rash, but they were managed with antihistamine administration and the treatment was continued.Four months later, the abnormal uptake on the right thoracic vertebrae shrunk; the pain almost disappeared, and oxycodone and fentanyl orally disintegrating tablet were discontinued.Subsequently, exemestane was used alone.Six months later, the range of abnormal uptake on the thoracic vertebrae progressed, and the disease was evaluated as PD.Four months later, everolimus and exemestane combination therapy was resumed, and the abnormal uptake on the thoracic vertebrae almost disappeared as observed on a PET scan.The effectiveness of the treatment was evaluated as CR because other local recurrence and new metastases were not found. Everolimus might exhibit bone resorption inhibiting effects and bone protection effects, but the decision regarding the periods of suitable use and the effects of long-term continuation of treatment are controversial, and further discussion based on experience of increasing use is required.
authors.affiliation: Dept. of Surgery, JCHO Tokuyama Central Hospital.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kubo
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kimura
authors.forename: Toru
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Makoto
authors.initials: M
authors.lastname: Miyahara
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Shimizu
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nagashima
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000730:Androstadienes / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000068338:Everolimus / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D000068338:Everolimus; C056516:exemestane