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

2016

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

 

  1. Kisqali. SUMMARY OF PRODUCT CHARACTERISTICS. August 2017
  2. 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.

SI2211240495

 

 

 

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