A CASE OF ABC WITH LUNG AND BONE METASTASIS
56 years old patient
04/2016:
Primary diagnosis of invasive BC (right side, NST, G2)
pT2, pN0, M0, L0, V0, R0 ER+ (100%)/PR+ (80%)/HER2- (1+)
- Breast-conserving surgery and SNB
- 6xFEC
- Radiation therapy
- 5 years of tamoxifen
10/2016:
Bone and lung metastases
Symptoms:
Mild to moderate pain (LWS) and fatigue. NO shortness of breath
CT scan:
Righ lung and bone metastases at lumbar spine (no evidence of risk for fracture)
Bronchoscopy:
ER+ (90%), PR–, HER2– (1+)
DIAGNOSIS:
Breast cancer with bone and lung metastases
11/2016:
ribociclib (600mg/d, d1–d21, q29d) (RIBECCA trial)
letrozole (2.5mg/d)
denosumab (120mg q29d)
Blood tests were performed at the beginning of the therapy and every two weeks for the first five months.
Blood tests were performed at the beginning of the therapy and every two weeks for the first five months.
Partial response in 01/2017 Patient
is still on treatment (400mg/d)
Until 09/2018: stable disease
No pain, good quality of life
FEMALE, 56-YEAR-OLD
Patient presentation and diagnosis 2016 |
November |
January 2017 |
January 2017 |
September 2018 |
DIAGNOSIS: Right breast cancer (NST, G2) pT2, pN0, M0, L0, V0, R0 ER+, PR+, HER2– |
Bone and pulmonary metastasis |
Leucopenia Neutropenia |
After 2 weeks, Normal blood tests |
Stable disease No pain Good QoL |
TREATMENT: Conserving surgery + SNB Chemotherapy Radiation therapy Tamoxifen for 5 years |
TREATMENT: ribociclib 600mg for 21 days + letrozole 2.5mg once daily + denosumab 120mg 4-weekly |
TREATMENT: ribociclib discontinuation |
TREATMENT: ribociclib restart 400mg |
Treatment ongoing |
- Kisqali. SUMMARY OF PRODUCT CHARACTERISTICS. August 2017
- Hortobagyi GN et al. Updated results from MONALEESA-2, a phase III trial of first-line Kisqali plus letrozole versus placebo plus letrozole in hormone receptor-positive, HER2-negative advanced breast cancer. Annals of Oncology 29: 1541–1547, 2018
Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain
This case was created by Andreas Hartkopt, MD
Author takes full responsibility for presented information which reflect author’s stand/practice and might not be in line with local approved SmPC.