Apatinib + CPT-11 + S-1 for treatment of refractory brain metastases in patient with triple-negative breast cancer: Case report and literature review

Medicine (Baltimore). 2018 Apr;97(15):e0349. doi: 10.1097/MD.0000000000010349.

Abstract

Rationale: Brain metastasis (BM) is a rising challenge in forward-looking oncology, as its treatment choices are very limited, especially, after the failure of local treatment schemes.

Patient concerns: We report on a 39-year-old Chinese woman who was diagnosed with stage IV triple-negative breast cancer(TNBC) with multiple brain, lung, and bone metastases. She had previously, undergone whole-brain radiation therapy. Paclitaxel, platinum, UTD1, capecitabine, gemcitabine, vinorelbine, and single-agent apatinib were then administered as first- to fifth-line therapies. She exhibited progression each time after a short period of disease stabilization.

Diagnoses: Triple-negative breast cancer.

Interventions: The patient chose treatment with apatinib+CPT-11+S-1 as the sixth-line therapy.

Outcomes: A remarkable response of the brain, and lung metastases, and alleviation of the brain edema were achieved, and these effects persisted for 7 months.

Lessons: We describe the significant anti-tumor effect of apatinib + CPT-11 + S-1 against BMs from breast cancer. This report is the first to suggest potential approaches to BM treatment using this scheme and describes the effects of an apatinib-containing regimen on BMs.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Edema / drug therapy
  • Brain Edema / pathology
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives*
  • Disease Progression
  • Drug Combinations
  • Female
  • Humans
  • Irinotecan
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary
  • Neoplasm Staging
  • Oxonic Acid / administration & dosage*
  • Pyridines / administration & dosage*
  • Tegafur / administration & dosage*
  • Triple Negative Breast Neoplasms / drug therapy*
  • Triple Negative Breast Neoplasms / pathology

Substances

  • Drug Combinations
  • Pyridines
  • S 1 (combination)
  • Tegafur
  • apatinib
  • Oxonic Acid
  • Irinotecan
  • Camptothecin