Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8425-8430
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8425
Abemaciclib-induced lung damage leading to discontinuation in brain metastases from breast cancer: A case report
Hiroyasu Yamashiro, Nao Morii
Hiroyasu Yamashiro, Nao Morii, Department of Breast Surgery, Tenri Hospital, Nara, Tenri 632-8552, Japan
Author contributions: Yamashiro H and Morii N contributed to manuscript writing and editing; all authors have read and approved the final manuscript.
Informed consent statement: Although the informed written consent cannot be obtained because the patient has already died, I can state clearly that this case report does not contain information that could identify the individual patient.
Conflict-of-interest statement: Hiroyasu Yamashiro received honoraria from Chugai, Novartis, Takeda, Eisai, Daiichi-Sankyo and AstraZeneca, Pfizer, Eli Lilly and Kyowa-Kirinoutside this work. Nao Morii received honoraria from Eli Lilly outside this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiroyasu Yamashiro, MD, PhD, Director, Department of Breast Surgery, Tenri Hospital, No. 200 Mishima-cho, Nara, Tenri 632-8552, Japan. yamashiro.bcs@gmail.com
Received: October 11, 2023
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
Abstract
BACKGROUND

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).

CASE SUMMARY

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.

CONCLUSION

This case underscores the challenge of managing adverse events in responsive brain metastasis patients, given the scarcity of therapeutic options.

Keywords: Breast cancer; HER2 negative; Brain metastasis; Abemaciclib; Drug-induced interstitial lung damage; Case report

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.