Cai JH, Zheng JH, Lin XQ, Lin WX, Zou J, Chen YK, Li ZY, Chen YX. Individualized treatment of breast cancer with chronic renal failure: A case report and review of literature. World J Clin Cases 2021; 9(33): 10345-10354 [PMID: 34904109 DOI: 10.12998/wjcc.v9.i33.10345]
Corresponding Author of This Article
Ye-Xi Chen, MD, Chief Doctor, Professor, Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou 515041, Guangdong Province, China. yxchen3@stu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Jie-Hui Cai, Jie-Hua Zheng, Xiao-Qi Lin, Wei-Xun Lin, Juan Zou, Yao-Kun Chen, Zhi-Yang Li, Ye-Xi Chen, Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Xiao-Qi Lin, Wei-Xun Lin, Juan Zou, Yao-Kun Chen, Breast Disease Research Center, The Medical Research Institute of Shantou Doctoral Association, Shantou 515041, Guangdong Province, China
Author contributions: Cai JH and Zheng JH are the patient’s doctors, and they reviewed the literature and contributed to manuscript drafting; Lin WX, Zou J, and Li ZY reviewed the literature, analyzed and explained the results of laboratory examinations, imaging examinations and pathological examinations; Lin XQ and Chen YK collected patient information and examination data, designed and produced the figures and tables; Chen YX reviewed the literature, contributed to manuscript drafting and revised the manuscript; all authors participated in the discussion and formulation of patient chemotherapy regimens and drug dosage adjustments, and issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the editor of this journal.
Conflict-of-interest statement: The authors report no conflicts of interest in 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye-Xi Chen, MD, Chief Doctor, Professor, Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, No. 69 North Dongxia Road, Shantou 515041, Guangdong Province, China. yxchen3@stu.edu.cn
Received: July 8, 2021 Peer-review started: July 8, 2021 First decision: August 18, 2021 Revised: September 5, 2021 Accepted: September 22, 2021 Article in press: September 22, 2021 Published online: November 26, 2021
Abstract
BACKGROUND
Studies have shown that patients with chronic renal failure (CRF) are more likely to suffer from breast cancer and other malignant tumors. To our knowledge, CRF can reduce drug excretion, thereby increase drug exposure and lead to increased toxicity, which will limit drug treatment and lead to tumor progression. Currently, there are few successful reports on the combination of docetaxel, trastuzumab, and pertuzumab (THP) as a neoadjuvant treatment regimen for breast cancer patients with CRF.
CASE SUMMARY
We report a breast cancer (cT2N2M0, Her-2+/HR-) patient with CRF. It was a clinical stage IIIA tumor on the left breast. The patient had suffered from uremia for 2 years, and her heart function was normal. Based on the pathological type, molecular type, and clinical stage of breast cancer, and the patient’s renal function, the clinician analyzed the pharmacological and pharmacokinetic characteristics of the antitumor drugs after consulting the relevant literature, and prescribed the neoadjuvant regimen of THP (docetaxel 80 mg/m², trastuzumab 8 mg/kg for the first dose, and 6 mg/kg for the maintenance dose with pertuzumab 840 mg for the first dose and 420 mg for the maintenance dose), once every 3 wk, for a total of 6 courses. The neoadjuvant treatment had a good effect, and the patient then underwent surgery which was uneventful.
CONCLUSION
CRF is not a contraindication for systemic treatment and surgery of breast cancer. The THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with CRF.
Core Tip: Renal failure is an important factor limiting the treatment of breast cancer because of the nephrotoxicity of anticancer drugs. There are few successful case reports of the combination of docetaxel, trastuzumab and pertuzumab (THP), especially pertuzumab, as a preoperative neoadjuvant treatment regimen for breast cancer patients with chronic renal failure (CRF) and few pharmacokinetic studies are available on renal failure in these patients. This report describes a breast cancer patient with CRF, which shows the safety of pertuzumab and effectiveness of the THP preoperative neoadjuvant treatment regimen.
