Antitumor Response of an ERBB2 Amplified Inflammatory Breast Carcinoma With EGFR Mutation to the EGFR-TKI Erlotinib

摘要: A 53-year-old woman was referred to our institution fortreatment recommendations for her advanced inflammatorybreast carcinoma (IBC) that continued progress locally despiteoptimal HER2-targeted therapy. She initially presented 2 yearsearlier with clinical signs suggestive of a right IBC. underwentadiagnosticcoreneedlebiopsy,which demonstrated an invasiveductal carcinoma, Grade 3, dermolymphatic emboli. Theprimary tumor tested negative the expression estrogenreceptor (ER) and progesterone receptor (PR) using immuno-histochemistry (IHC) HER2 3þ IHC. At timeof initial diagnosis had metastasized multiple bonesand liver, patient staged as T4dN1M1 (liver andbone) stage IV.The began treatment trastuzumab (Herceptin)combined docetaxel (Taxotere) carboplatin (Paraplatin)and achieved excellent radiological response. Eightmonths later, developed expressive aphasia, mag-netic resonance imaging (MRI) computed tomography imagingconfirmed single metastatic lesion in left frontoparietal region.Subsequent craniotomy revealed 2.4-cm ER-negative/PR-negative/HER2 metastasis. month MRI scanrevealed second 0.5-cm brain metastasis subsequentlytreated gamma knife irradiation.Considering persistence systemic disease other sites,chemotherapy capecitabine (Xeloda) laptinib (Tykerb) wasinitiated.Threemonthslater,thepatientagainrequiredtreatmentwithgamma irradiation additional cerebral metastases. Shecontinued apparent bene fit, but 4 monthslater,imagingforrestagingshowedprogressivein filtrationintothechestwall increased metabolic activity local lymph nodes. Tras-tuzumab added current regimen. Despite