Abemaciclib-induced lung damage leading to discontinuation in brain metastases from breast cancer: A case report

Unusual presentation of luminal breast carcinoma metastatic to the brain and coma: a case report of dramatic response to abemaciclib and literature review

Patients with luminal breast cancer (BC) may develop central nervous system metastases in 20%-40% of cases. Radiation or surgical therapy represents the cornerstone of treating central nervous system metastases. Meanwhile, the best practice for metastatic luminal BC involves using cyclin-dependent kinase 4/6 inhibitors combined with endocrine therapy. To our knowledge, this is the first case to report a dramatic response of breast metastases to abemaciclib plus endocrine therapy without radiation therapy, particularly in a patient who presented with seizures and sudden coma. She received brain surgery to control a large bleeding metastasis. Abemaciclib was crushed and diluted in water for administration via the nasogastric tube, while an upfront fulvestrant was given since aromatase inhibitors cannot be diluted. Beyond the radiological response, the clinical improvement was notable, with complete symptom recovery to the point where she is again working. Our paper supports the activity of abemaciclib in brain metastases from luminal BC and includes a review of the medical literature. Further investigation is warranted in this clinical setting.

Long-Term Control of Breast Cancer Brain Metastases Using Abemaciclib and Letrozole Combination Therapy: A Case Report

Breast cancer brain metastases are among the most common distant metastases and have a poor prognosis. However, the effects of subtype-specific systemic therapy on breast cancer brain metastases are unknown. This report highlights the long-term control of breast cancer brain metastases using abemaciclib and letrozole combination therapy without severe side effects. We report a case of a middle-aged premenopausal female patient who experienced convulsions and was diagnosed with hormone receptor-positive breast cancer brain metastases. After standard-of-care whole-brain radiation therapy, systemic chemotherapy was administered, and the primary tumor and multiple brain metastases were sufficiently reduced. However, treatment was discontinued because peripheral neuropathy worsened. Abemaciclib, letrozole, and luteinizing hormone-releasing hormone agonists were administered as maintenance therapy. The treatment maintained a stable disease and no new lesions were observed. Cyclin-dependent kinase 4/6 inhibitors and endocrine maintenance therapy are effective treatments for breast cancer brain metastases.

Case report: outcome of anlotinib treatment in breast cancer patient with brain metastases

Brain metastases (BM) represent a common and severe complication of breast cancer (BC), emerging in approximately 10%-16% of all BC patients. The prevalent approach for treating BC patients with BM encompasses a multimodal strategy, combining surgery, whole brain radiation therapy, and stereotactic radiosurgery. Yet, a concrete guideline for localized treatment strategies remains elusive, while systemic treatments like small-molecule-targeted therapy and immunotherapy are still in the clinical trial phase. This case study presents a significant clinical response to anlotinib treatment in a patient with estrogen receptor-negative, progesterone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-positive breast cancer, complicated by BM. After the standard first-line treatment including albumin-bound paclitaxel, trastuzumab and pertuzumab, and a second-line treatment involving pyrotinib, capecitabine, and radiotherapy did not produce the desired results, the patient was then administered anlotinib in combination with pyrotinib and letrozole as a third-line treatment, which led to a partial response (PR). The findings suggest that anti-angiogenic therapy, specifically anlotinib, could be regarded as a promising therapeutic option for BC patients with BM.