Breast cancer
Theragnostic testing – choosing the right therapy in mTNBC

Fatima (63 years old)

Fatima is 63 years old and is diagnosed with mTNBC. Every time she has to go the hospital, she turns on her playlist with power songs to boost her motivation for battling the disease.

Assessment summary

  • Postmenopausal
  • No relevant family history
  • Genetic testing: no gBRCA1/2 pathogenic variants
  • No relevant comorbidities
  • ECOG PS: 0
  • Medical history
    • 4 years ago, diagnosed with early stage TNBC (cT2N0M0)
      • Neoadjuvant anthracycline-taxane chemotherapy
      • Mastectomy + SLNB (R0 resection, LVI absent, G2, no pCR: ypT2 ypN0)
      • Post-neoadjuvant capecitabine (6 cycles)
    • 15 months ago, staging including CT scan of chest/abdomen and bone scan: 3 liver lesions
      • Biopsy (liver lesion)
        • Breast cancer, ER 0%, PgR 0%, HER2 IHC 1+, G2
        • PD-L1 status: CPS 12, IC score 0%
      • First-line treatment for liver metastases: pembrolizumab + chemotherapy for 9 months (best response: partial response)
      • Second-line treatment for liver progression: eribulin for 6 months (best response: stable disease)
  • Today, CT scan of chest/abdomen and bone scan: progression of liver metastases and 2 new bone lesions

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