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Clinical benefit of fulvestrant monotherapy in the multimodal treatment of hormone receptor and HER2 positive advanced breast cancer: a case series

Authors Rusz O, Kószó R, Dobi Á, Csenki M, Valicsek E, Nikolényi A, Uhercsák G, Cserháti A, Kahán Z

Received 11 April 2018

Accepted for publication 21 June 2018

Published 4 September 2018 Volume 2018:11 Pages 5459—5463


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Arseniy Yuzhalin

Orsolya Rusz, Renáta Kószó, Ágnes Dobi, Melinda Csenki, Erzsébet Valicsek, Alíz Nikolényi, Gabriella Uhercsák, Adrienne Cserháti, Zsuzsanna Kahán

Department of Oncotherapy, University of Szeged, Szeged, Hungary

Abstract: Fulvestrant is a pure estrogen receptor (ER) antagonist approved for the treatment of metastatic ER positive breast cancer in postmenopausal women with disease progression following antiestrogen therapy. The clinical results of fulvestrant demonstrated encouraging activity in tumors in spite of HER2 positivity, but data about its use after progression on anti-HER2 agents are limited. Partial responses and durations of response of 12, 25, and 38 months in three cases with multiple metastases of ER positive and HER2 positive breast cancer were observed; all patients had been treated with 1–4 regimens of an anti-HER2 agent in combination with chemotherapy or an aromatase inhibitor before the initiation of fulvestrant. Fulvestrant is a valuable option with limited toxicity and durable response in metastatic HER2 and ER positive breast cancer after progression on anti-HER2 agents as well. Therapeutic benefit even in extensive skin metastases and (irradiated) brain metastases may be expected. Further investigations are warranted to establish where it fits into the multimodal management of ER and HER positive breast cancer.

Keywords: endocrine resistance, trastuzumab resistance, brain metastasis, skin metastasis

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