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Biswas G, Subudhi GC, Biswas S, Das B. Long-Term Success With a TDM-1 Biosimilar in Recurrent HER2-Positive Breast Cancer With Multisite Metastases: A Comprehensive Case Study. Cureus 2024; 16:e67047. [PMID: 39290925 PMCID: PMC11406474 DOI: 10.7759/cureus.67047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/19/2024] Open
Abstract
This case report highlights the treatment approaches for breast cancer with metastasis to multiple sites, including the brain, liver, lungs, and bones. It also explores the role of trastuzumab emtansine (T-DM1) and its biosimilar as targeted therapies for HER2-positive breast cancer in long-term treatment. A 54-year-old postmenopausal female patient with recurrent breast cancer and metastasis was treated with trastuzumab and paclitaxel (12 cycles), followed by trastuzumab maintenance therapy (71 cycles). She received radiation therapy of 30 Gy in 10 fractions after presenting with bleeding from the breast lesion. Oral therapy with lapatinib and letrozole was prescribed for a year to treat the breast cancer, along with the lesions and enhanced nodules observed in the patient's lungs, liver, and bones. A year later, she presented with complaints of seizures and loss of consciousness and was diagnosed with brain metastasis. Whole-brain radiation therapy (WBRT) was administered after performing contrast-enhanced computed tomography (CECT). The WBRT was followed by trastuzumab emtansine (T-DM1) biosimilar therapy. Currently, the patient has received more than 30 cycles of T-DM1 and has survived while maintaining a good quality of life. The patient has survived 7.5 years in a stable disease condition after the detection of recurrent breast cancer with metastasis to the liver, lungs, bones, and brain. This case report demonstrates the long-term efficacy of T-DM1 and its satisfactory safety profile. Overall, it provides valuable insights into the management of and challenges faced during the treatment of recurrent breast cancer with metastasis.
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Affiliation(s)
| | | | - Sutapa Biswas
- Pathology, Sparsh Hospitals and Critical Care, Bhubaneswar, IND
| | - Bharat Das
- Palliative Care, Sparsh Hospitals and Critical Care, Bhubaneswar, IND
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Pham TM, Cao DV, Dang HHQ, Mai PMT, Nguyen TB, Dinh NBN, Nguyen TKG, Le TMH, Doan VD, Nguyen DT, Le VT. 153Sm-labeled Fe 3O 4@lapatinib nanoparticles as a potential therapeutic agent for breast cancer: synthesis, quality control, and in vivo evaluation. J Mater Chem B 2024; 12:678-690. [PMID: 38116646 DOI: 10.1039/d3tb01957h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
The present study introduces Fe3O4-coated lapatinib-labeled 153Sm nanoparticles (denoted as Fe3O4@lapatinib-153Sm) as a promising avenue for advancing breast cancer treatment. The radiolabeled nanoparticles combine various attributes, offering enhanced therapeutic precision. The integration of lapatinib confers therapeutic effects and targeted delivery. The inherent magnetic characteristics of Fe3O4 nanoparticles contribute to improved imaging contrast and targeted localization. Incorporating the gamma-emitting 153Sm isotope permits single-photon emission computed tomography imaging and radiation dose evaluation, while its beta-emitting nature ensures targeted cancer cell eradication. The synthesis of Fe3O4@lapatinib-153Sm was meticulously optimized by investigating the effects of parameters on radiolabeling efficiency. Physicochemical attributes were scrutinized using several analytical techniques. In-depth in vivo assessment evaluated the biocompatibility, toxicity, and biodistribution in a murine model, illuminating clinical utility. Optimal conditions (153SmCl3 concentration of 10 mCi mL-1, pH 7.4, a reaction time of 30 min, and a temperature of 25 °C) achieved >99% labeling efficiency and radiochemical purity. The TEM analysis indicated that the diameter of Fe3O4@lapatinib-153Sm nanoparticles ranged from 10 to 40 nm. Vibrating-sample magnetometry verified their superparamagnetic behaviour with a saturation magnetization of 41.4 emu g-1. The synthesized radiopharmaceutical exhibited high sterility and in vitro stability. Acute toxicity studies showed the mild effects of Fe3O4@lapatinib-153Sm at a dose of 20 mCi kg-1, with no observed mortality. Notably, lesions from Fe3O4@lapatinib-153Sm use recovered naturally over time. Radiation doses below 20 mCi kg-1 were recommended for clinical trials. The biodistribution study in BT474 xenograft mice revealed rapid clearance of Fe3O4@lapatinib-153Sm within 48 h. Significant accumulation occurred in the liver, spleen, and tumor tissue, while minimal accumulation was found in other tissues. Future steps involve studying biocorona formation and therapeutic efficacy on tumour models, refining its clinical potential.
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Affiliation(s)
- Thanh Minh Pham
- Dalat Nuclear Research Institute, 01 Nguyen Tu Luc, Dalat, 670000, Vietnam.
| | - Dong Vu Cao
- Dalat Nuclear Research Institute, 01 Nguyen Tu Luc, Dalat, 670000, Vietnam.
| | - Ho Hong Quang Dang
- Dalat Nuclear Research Institute, 01 Nguyen Tu Luc, Dalat, 670000, Vietnam.
| | | | - Thanh Binh Nguyen
- Dalat Nuclear Research Institute, 01 Nguyen Tu Luc, Dalat, 670000, Vietnam.
| | - Ngoc Bao Nam Dinh
- Dalat Nuclear Research Institute, 01 Nguyen Tu Luc, Dalat, 670000, Vietnam.
| | | | - Thi Mai Huong Le
- Nuclear Training Center, Vietnam Atomic Energy Institute, 140 Nguyen Tuan Street, Thanh Xuan District, Hanoi, 110430, Vietnam
| | - Van Dat Doan
- The Faculty of Chemical Engineering, Industrial University of Ho Chi Minh City, Ho Chi Minh City, 70000, Vietnam
| | - Duc Thuan Nguyen
- Lam Dong Department of Health, 36 Tran Phu, Lam Dong, 670000, Vietnam
| | - Van Thuan Le
- Center for Advanced Chemistry, Institute of Research and Development, Duy Tan University, 03 Quang Trung, Da Nang, 550000, Vietnam.
- Faculty of Natural Sciences, Duy Tan University, 03 Quang Trung, Da Nang, 550000, Vietnam
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Swaminathan H, Saravanamurali K, Yadav SA. Extensive review on breast cancer its etiology, progression, prognostic markers, and treatment. Med Oncol 2023; 40:238. [PMID: 37442848 DOI: 10.1007/s12032-023-02111-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
As the most frequent and vulnerable malignancy among women, breast cancer universally manifests a formidable healthcare challenge. From a biological and molecular perspective, it is a heterogenous disease and is stratified based on the etiological factors driving breast carcinogenesis. Notably, genetic predispositions and epigenetic impacts often constitute the heterogeneity of this disease. Typically, breast cancer is classified intrinsically into histological subtypes in clinical landscapes. These stratifications empower physicians to tailor precise treatments among the spectrum of breast cancer therapeutics. In this pursuit, numerous prognostic algorithms are extensively characterized, drastically changing how breast cancer is portrayed. Therefore, it is a basic requisite to comprehend the multidisciplinary rationales of breast cancer to assist the evolution of novel therapeutic strategies. This review aims at highlighting the molecular and genetic grounds of cancer additionally with therapeutic and phytotherapeutic context. Substantially, it also renders researchers with an insight into the breast cancer cell lines as a model paradigm for breast cancer research interventions.
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Affiliation(s)
- Harshini Swaminathan
- Department of Biotechnology, Karpagam Academy of Higher Education, Coimbatore, 641021, Tamil Nadu, India
| | - K Saravanamurali
- Virus Research and Diagnostics Laboratory, Department of Microbiology, Coimbatore Medical College, Coimbatore, India
| | - Sangilimuthu Alagar Yadav
- Department of Biotechnology, Karpagam Academy of Higher Education, Coimbatore, 641021, Tamil Nadu, India.
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