Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8425
Peer-review started: October 11, 2023
First decision: October 24, 2023
Revised: November 4, 2023
Accepted: November 30, 2023
Article in press: November 30, 2023
Published online: December 16, 2023
Processing time: 64 Days and 0.4 Hours
This case report addresses the dearth of effective therapeutic interventions for central nervous system metastases in patients with HER2-negative breast cancer. It presents a unique case of a woman with estrogen receptor-positive, HER2-negative breast cancer who developed brain metastasis. The report highlights her initial favorable response to abemaciclib and letrozole therapy prior to the discontinuation due to drug-induced lung damage (DILD).
In this comprehensive case summary, we present the clinical course of a woman in her 60s, who 11 years following primary breast cancer surgery, was diagnosed with multiple brain metastases. As a third-line systemic therapy, she underwent treatment with abemaciclib and letrozole. This treatment approach yielded a near-partial response in her metastatic brain lesions. However, abemaciclib administration ceased due to the emergence of DILD, as confirmed by a computed tomography scan. The DILD improved after 1 mo of cessation. Despite ongoing therapeutic efforts, the patient’s condition progressively deteriorated, ultimately resulting in death due to progression of the brain metastases.
This case underscores the challenge of managing adverse events in responsive brain metastasis patients, given the scarcity of therapeutic options.
Core Tip: In this case report, we address the critical issue of limited therapeutic options for HER2-negative breast cancer patients with brain metastases. We present a case of a woman with estrogen receptor-positive, HER2-negative breast cancer who initially exhibited an encouraging response to abemaciclib and letrozole therapy for brain metastases. However, this treatment had to be discontinued due to drug-induced lung damage. This study reports the challenges of achieving a balance between efficacy and adverse events in managing brain metastases and highlights the need for alternative treatment strategies in this patient population.