Breast cancer
Theragnostic testing – choosing the right therapy in mTNBC

Petra (64 years old)

Petra, 64 years old, intended to train for a 10 km walk after her treatment for early stage TNBC. Unfortunately, her physical condition never allowed her to properly start training, and now she is diagnosed with mTNBC.

Assessment summary

  • Postmenopausal
  • Cancer family history: mother had ovarian cancer at the age of 70 years
    • Genetic panel analysis: no pathogenic variants in BRCA1/2 and PALB2
  • Medical history
    • Hashimoto-thyroiditis (well-controlled hypothyroidism, normal thyroid function parameters under l-thyroxin 50 µg/d), mild arterial hypertonia
    • Diagnosis early stage TNBC (cT2N1M0, right side)
      • Neoadjuvant anthracycline-taxane chemotherapy
      • Mastectomy, sentinel lymphadenectomy and targeted axillary dissection (pCR: ypT0 ypN0)
  • Today, 16 months later, staging including CT scan of chest/abdomen and bone scan
    • 2 suspicious liver lesions and multiple suspicious pleural lesions
    • Biopsy (liver lesion)
      • Breast cancer, ER 0%, PgR 0%, HER2 IHC 1+, G2
      • PD-L1 status: CPS 6, IC score 5%
  • ECOG PS: 0

Which of the following treatment options would you choose for this patient?