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Pembrolizumab response in stage IV luminal-type breast cancer with high microsatellite instability: a case report.
Inakami, Keiko; Fujita, Noriko; Iguchi, Chikage; Enomoto, Yukie; Minohata, Junya; Sata, Atsushi; Miyagawa, Yoshimasa; Yanagisawa, Tetsu; Saitoh, Tomokazu; Nomura, Takashi; Sawai, Yuka; Takahara, Keiko; Kasugai, Tsutomu; Shiba, Eiichi.
Afiliación
  • Inakami K; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan. inakami1113@icloud.com.
  • Fujita N; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Iguchi C; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Enomoto Y; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Minohata J; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Sata A; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Miyagawa Y; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Yanagisawa T; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Saitoh T; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Nomura T; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
  • Sawai Y; Department of Radiology, Osaka Breast Clinic, Osaka, Japan.
  • Takahara K; Department of Radiotherapy, Osaka Breast Clinic, Osaka, Japan.
  • Kasugai T; Department of Pathology, Osaka Breast Clinic, Osaka, Japan.
  • Shiba E; Department of Breast and Endocrine Surgery, Osaka Breast Clinic, 1-13-8 Ohiraki Fukushima, Osaka, 553-0007, Japan.
J Med Case Rep ; 18(1): 214, 2024 May 01.
Article en En | MEDLINE | ID: mdl-38689362
ABSTRACT

BACKGROUND:

Pembrolizumab (PEM), an immune checkpoint inhibitor (ICI), is often used for triple-negative breast cancer, but can also be used to treat solid tumors that exhibit high microsatellite instability (MSI-High). However, patients with breast cancer rarely have MSI-High, the use of PEM in such cases in clinical practice is uncertain due to lack of sufficient supporting data. Here, we report the case of a premenopausal woman in who received PEM for MSI-High luminal-type breast cancer. CASE PRESENTATION A 40-year-old premenopausal Asian woman was diagnosed with stage IIA (T2N0M0) breast cancer and had an Oncotype DX recurrence score of 38. After surgery, she received 4 courses of chemotherapy with docetaxel and cyclophosphamide. After 3 months of tamoxifen therapy, the patient complained of abdominal pain due to right iliac metastasis, and biopsy of the metastatic lesion showed of luminal type; she was sequentially treated with fulvestrant, a CDK4/6 inhibitor, and an anticancer drug (TS1), but over the next year, metastasis to the bone and para-aortic lymph nodes increased. Tumor was MSI-High; PEM was started, and after three courses, bone metastases were reduced, para-aortic lymph node metastases resolved, opioids were discontinued, and the patient returned to society; PEM was administered for 1 year with no worsening of bone metastases on imaging. Asymptomatic brain metastasis less than 1 cm was detected and gamma knife was performed. Six months after completion of PEM, the patient is working with no new lesions.

CONCLUSION:

We report a case of luminal-type breast cancer with bone metastases and MSI-High, which was treated with PEM and showed a rapid therapeutic response.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Inestabilidad de Microsatélites / Anticuerpos Monoclonales Humanizados Límite: Adult / Female / Humans Idioma: En Revista: J Med Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Inestabilidad de Microsatélites / Anticuerpos Monoclonales Humanizados Límite: Adult / Female / Humans Idioma: En Revista: J Med Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido