Breast cancer
Theragnostic testing – choosing the right therapy in mTNBC

Chiara (59 years old)

Chiara is a 59-year-old woman with a history of mTNBC. When she was initially diagnosed with cancer, she started doing yoga as a way to relief her stress. Now, she couldn’t imagine her life without it.

Assessment summary

  • Postmenopausal
  • No relevant family history
  • Genetic testing: no BRCA1/2 pathogenic variants
  • ECOG PS: 1
  • Medical history
    • 2.5 years ago: diagnosis early stage TNBC (T2N1M0, left side)
      • Tumour biology (breast lesion): ER 0%, PgR 0%, HER2 IHC 0, Ki67 30%, G2
      • Neoadjuvant chemotherapy: anthracycline-taxane + carboplatin
      • BCS + ALND (pCR: ypT0 ypN0)
      • Radiation therapy
    • 6 months ago: staging including CT scan of chest/abdomen and bone scan: 2 suspicious lesions in liver
      • Biopsy (liver lesion)
        • Breast cancer, ER 0%, PgR 0%, HER2 IHC 1+, Ki67 20%, G2
        • PD-L1 status: CPS 2, IC score 0%
      • Taxane monotherapy for 6 months
  • Today, CT scan of chest/abdomen showed progression of liver metastases

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