Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient
We describe the clinical and therapeutic course of a 51-year-old woman with HER-2+ breast cancer who developed leptomeningeal (LM) and spinal cord metastases after 8 years of stable disease on combination therapy with intravenous (IV) trastuzumab. Due to progressive CNS disease, intrathecal (IT) tra...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2015-09-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/3/1/41.full |
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| author | Nu T. Lu Jeffrey Raizer Erwin P. Gabor Natalie M. Liu James Q. Vu Dennis J. Slamon John L. Barstis |
| author_facet | Nu T. Lu Jeffrey Raizer Erwin P. Gabor Natalie M. Liu James Q. Vu Dennis J. Slamon John L. Barstis |
| author_sort | Nu T. Lu |
| collection | DOAJ |
| description | We describe the clinical and therapeutic course of a 51-year-old woman with HER-2+ breast cancer who developed leptomeningeal (LM) and spinal cord metastases after 8 years of stable disease on combination therapy with intravenous (IV) trastuzumab. Due to progressive CNS disease, intrathecal (IT) trastuzumab was introduced to enhance HER-2+ therapy into the CSF space. A combination HER-2+ targeted approach achieved clinical remission with stable disease in our patient 46 months after she was diagnosed with LM metastases. However, spinal cord C-1 metastasis was not fully controlled with IT trastuzumab, ultimately leading to the patient’s respiratory compromise. In our patient, IT trastuzumab immunotherapy improved prognosis and was an effective strategy to manage HER-2+ LM disease. Given alone or alongside other anti-HER-2+ therapeutics with sufficient CNS penetration, IT trastuzumab could extend the lifespan of patients with leptomeningeal and CNS metastases. |
| format | Article |
| id | doaj-art-5f6b0c92c3f84d509c3c78ceb6f359de |
| institution | Kabale University |
| issn | 2051-1426 |
| language | English |
| publishDate | 2015-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-5f6b0c92c3f84d509c3c78ceb6f359de2025-02-09T17:00:10ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262015-09-013110.1186/s40425-015-0084-yIntrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patientNu T. Lu0Jeffrey Raizer1Erwin P. Gabor2Natalie M. Liu3James Q. Vu4Dennis J. Slamon5John L. Barstis6Aff1 grid.19006.3e0000000096326718Division of Hematology/OncologyUCLA School of Medicine 11-934 Factor Building 90025 Los Angeles CA USA7Takeda Development Center Americas, Inc. (TDCA), Lexington, MA, USAAff5 grid.19006.3e0000000096326718David Geffen School of Medicine, UCLA 90095 Los Angeles CA USAAff2 grid.19006.3e0000000096326718Department of Pathology & Laboratory Medicine, UCLA 90095 Los Angeles CA USAAff2 grid.19006.3e0000000096326718Department of Pathology & Laboratory Medicine, UCLA 90095 Los Angeles CA USAAff1 grid.19006.3e0000000096326718Division of Hematology/OncologyUCLA School of Medicine 11-934 Factor Building 90025 Los Angeles CA USAAff1 grid.19006.3e0000000096326718Division of Hematology/OncologyUCLA School of Medicine 11-934 Factor Building 90025 Los Angeles CA USAWe describe the clinical and therapeutic course of a 51-year-old woman with HER-2+ breast cancer who developed leptomeningeal (LM) and spinal cord metastases after 8 years of stable disease on combination therapy with intravenous (IV) trastuzumab. Due to progressive CNS disease, intrathecal (IT) trastuzumab was introduced to enhance HER-2+ therapy into the CSF space. A combination HER-2+ targeted approach achieved clinical remission with stable disease in our patient 46 months after she was diagnosed with LM metastases. However, spinal cord C-1 metastasis was not fully controlled with IT trastuzumab, ultimately leading to the patient’s respiratory compromise. In our patient, IT trastuzumab immunotherapy improved prognosis and was an effective strategy to manage HER-2+ LM disease. Given alone or alongside other anti-HER-2+ therapeutics with sufficient CNS penetration, IT trastuzumab could extend the lifespan of patients with leptomeningeal and CNS metastases.https://jitc.bmj.com/content/3/1/41.full |
| spellingShingle | Nu T. Lu Jeffrey Raizer Erwin P. Gabor Natalie M. Liu James Q. Vu Dennis J. Slamon John L. Barstis Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient Journal for ImmunoTherapy of Cancer |
| title | Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient |
| title_full | Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient |
| title_fullStr | Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient |
| title_full_unstemmed | Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient |
| title_short | Intrathecal trastuzumab: immunotherapy improves the prognosis of leptomeningeal metastases in HER-2+ breast cancer patient |
| title_sort | intrathecal trastuzumab immunotherapy improves the prognosis of leptomeningeal metastases in her 2 breast cancer patient |
| url | https://jitc.bmj.com/content/3/1/41.full |
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