Breast cancer
CDK4/6 inhibitors for everyone? Treatment strategies in HR+ HER2- advanced breast cancerJessy (58 years old)
Jessy, 58 years old, was diagnosed with primary metastatic breast cancer 17 months ago.
Assessment summary:
- Postmenopausal
- No relevant medical history, ECOG PS: 0
- No family history of breast cancer
- Diagnosed with primary metastatic breast cancer 17 months ago
- Imaging:
- 5 cm tumour in the right breast, 4 suspicious axillary lymph nodes
- Multiple suspicious lesions in bones and pleura
- Tumour biology: NST, ER 90%, PgR 70%, HER2 IHC 0, G2
Treatment with letrozole and CDK4/6i was started 1 month after diagnosis, which resulted in regression of bone and pleural metastases 5 months later and stable disease after 6 additional months.
Again 5 months later, i.e. 16 months after the start with letrozole and CDK4/6i:
- Imaging:
- Pleura: stable disease, bones: progression, new liver metastasis
- Biopsy of liver metastasis: ER 70%, PgR 40%, HER2 IHC 0, G2
- Somatic PIK3CA mutation status: wild type
- Germline BRCA mutation status: wild type