Long-term complete response to intrathecal trastuzumab in a patient with leptomeningeal carcinomatosis due to her2- overexpressing breast cancer: Case report

Introduction: Leptomeningeal dissemination due to HER2-overexpressing breast cancer is a rare and hard to treat complication with short-term dismal prognosis. Patient concerns: A 34-year-old female previously treated because of HER2+ breast cancer is admitted to the Neurology Department in December...

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Detalles Bibliográficos
Autores: García, Francisco José Valdivia, Carrión, Natalia Palazón, Cruz Merino, Luis de la
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/143982
Acceso en línea:https://hdl.handle.net/11441/143982
https://doi.org/10.1097/MD.0000000000018298
Access Level:acceso abierto
Palabra clave:Breast
Cancer
HER2
Intrathecal
Leptomeningeal carcinomatosis
Positive
Trastuzumab
Descripción
Sumario:Introduction: Leptomeningeal dissemination due to HER2-overexpressing breast cancer is a rare and hard to treat complication with short-term dismal prognosis. Patient concerns: A 34-year-old female previously treated because of HER2+ breast cancer is admitted to the Neurology Department in December 2016 due to sensory-motor neurological semiology. Diagnosis: A wide set of diagnostic tests is performed and finally cytologic findings after repeated CSF confirm leptomeningeal infiltration by breast carcinoma (panCK+, GATA3+). Interventions: Weekly intrathecal triple therapy with methotrexate, cytarabine and hydrocortisone plus trastuzumab is carried out during 4 months. Outcomes: Clinical and pathological response that lasts more than 24 months. Conclusion: Leptomeningeal carcinomatosis is an oncological situation where conventional therapies have limited activity. In HER2+ advanced breast cancer patients, intrathecal therapy with anti-HER2 therapy (trastuzumab) is feasible and may reach long-term disease control, especially in cases of low-tumor burden.