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Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report

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Abstract

We report a case of metastatic breast cancer with leptomeninges and multiple bone metastases that showed an excellent response to the combination of trastuzumab and capecitabine; therapeutic effect was evaluated by MRI at follow-up. A 44-year-old woman underwent modified radical mastectomy in February 1997. In April 2003, a tumor at the right basis cerebri and multiple bone metastases were noted, and in October 2003, she underwent enucleation of the tumor. Histopathologically, the tumor was consistent with a basal skull metastasis from breast cancer. In March 2004, the patient began to experience pain, weakness, and paresthesia of both legs. She was diagnosed, with leptomeningeal metastasis (LM) from breast cancer using MRI. In December 2005, the combination of trastuzumab and capecitabine administered as sixth-line treatment was very effective for LM. Although it is generally very difficult to diagnose LM and assess the therapeutic effect with MRI, in this case, it was possible. To our knowledge, there has been no report in the literature describing the combination of trastuzumab and capecitabine for LM from breast cancer. Although the mechanism underlying the efficacy of this combination is still unknown, the treatment would be worth trying because of its few side effects in extensively treated patients with LM from breast cancer. To confirm the antitumor efficacy of trastuzumab and capecitabine, however, further investigations are required.

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Abbreviations

LM:

Leptomeningeal metastasis

CSF:

Cerebrospinal fluid

HER2:

Human epidermal growth factor receptor-2

IHC:

Immunohistochemistry

FISH:

Fluorescence in situ hybridization

MBC:

Metastatic breast cancer

BBB:

Blood–brain barrier

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Authors and Affiliations

  1. Department of Breast Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Takashi Shigekawa, Hideki Takeuchi, Misono Misumi, Kazuo Matsuura, Hiroshi Sano, Nobuko Fujiuchi, Katsuhiko Okubo, Akihiko Osaki & Toshiaki Saeki

  2. Department of Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto, Matsuyama, Ehime, 791-0280, Japan

    Kenjiro Aogi

Authors
  1. Takashi Shigekawa
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  2. Hideki Takeuchi
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  3. Misono Misumi
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  9. Kenjiro Aogi
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  10. Toshiaki Saeki
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Correspondence to Takashi Shigekawa.

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Shigekawa, T., Takeuchi, H., Misumi, M. et al. Successful treatment of leptomeningeal metastases from breast cancer using the combination of trastuzumab and capecitabine: a case report. Breast Cancer 16, 88–92 (2009). https://doi.org/10.1007/s12282-008-0056-x

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  • DOI: https://doi.org/10.1007/s12282-008-0056-x

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