[Long-Term Response to CDK4/6 Inhibitor for Multiple Metastases of Breast Cancer].

Q4 Medicine Japanese Journal of Cancer and Chemotherapy Pub Date : 2024-10-01
Kenichi Sakurai, Shuhei Suzuki, Keita Adachi, Tomohiro Hirano, Hitomi Kubota, Ayaka Sakamoto, Akiko Osakaya, Shigeru Fujisaki, Toshiko Ono, Taiki Tsuji
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Abstract

The patient was a 60-year-old woman. She was diagnosed with hypertension, symptomatic epilepsy, renal failure, and cerebral infarction. During follow-up, she was found to have a mass in her left breast and was referred to our department. An irregular mass measuring 5 cm in diameter was palpated in the C region of the left breast. Multiple enlarged lymph nodes, thought to be metastases, were also palpated in the ipsilateral axillary lymph nodes. A needle biopsy revealed invasive ductal carcinoma, ER positive, PgR positive, HER2 negative, Ki-67 12%. A systemic examination revealed bone metastasis. Surgery was not possible due to comorbidities, so fulvestrant(500 mg/month)+denosumab(120 mg/month)was started. Furthermore, as the tumor markers were elevated, abemaciclib(300 mg/day)was added, which resulted in a decrease in the tumor markers. After 1 month of administration, grade 3 neutropenia was observed, so the dosage was reduced to 200 mg/day. During the course of treatment, the tumor markers rose again, so the dose was increased to 250 mg/day, which resulted in a decrease in the tumor markers and good tolerability. At present, 36 months after the start of treatment, long SD has continued, no adverse events of grade 3 or higher have been observed, and the drug has been well tolerated.

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[CDK4/6抑制剂治疗乳腺癌多处转移的长期疗效]。
患者是一名 60 岁的女性。她被诊断患有高血压、症状性癫痫、肾功能衰竭和脑梗塞。在随访期间,她发现左侧乳房有肿块,于是被转诊到我科。在左侧乳房 C 区触及直径 5 厘米的不规则肿块。同侧腋窝淋巴结也触及多个肿大的淋巴结,被认为是转移灶。针刺活检显示为浸润性导管癌,ER阳性,PgR阳性,HER2阴性,Ki-67 12%。全身检查显示有骨转移。由于合并症,无法进行手术,因此开始使用氟维司群(500 毫克/月)+地诺单抗(120 毫克/月)。此外,由于肿瘤标志物升高,患者又服用了阿柏西尼(300 毫克/天),结果肿瘤标志物有所下降。用药1个月后,观察到3级中性粒细胞减少症,因此剂量减至200毫克/天。在治疗过程中,肿瘤标志物再次上升,因此剂量增加到 250 毫克/天,结果肿瘤标志物下降,耐受性良好。目前,在开始治疗 36 个月后,长效 SD 仍在继续,未发现 3 级或以上的不良反应,药物耐受性良好。
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