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Clinical Oncology

APRIL 10, 2019

[CDK 4/6 Inhibitors in Breast Cancer: Current Controversies and Future Directions]

SPRING M. Laura, WANDER A. Seth, ZANGARDI Mark, BARDIA Aditya

[Purpose of review: To describe the clinical role of CDK 4/6 inhibitors in hormone receptor-positive (HR+) metastatic breast cancer (HR+MBC) as well as current controversies and evolving areas of research. Recent fi ndings: Palbociclib, ribociclib, and abemaciclib are each approved in combination with an aromatase inhibitor or fulvestrant for HR+MBC. Abemaciclib is also approved as monotherapy for pre-treated patients. Key questions in the fi eld include whether all patients with HR+MBC should receive a CDK 4/6 inhibitor up front versus later line, impact on overall survival, role of continued CDK 4/6 blockade, mechanism of clinical resistance, and treatment sequencing. Summary: The development of CDK 4/6 inhibitors has changed the therapeutic management of HR+MBC. Additional research is needed to determine optimal treatment sequencing, understand mechanisms governing resistance, and develop novel therapeutic strategies to circumvent or overcome clinical resistance and further improve the outcomes of patients with MBC.]

Lege Artis Medicinae

DECEMBER 15, 2017

[Long survival with multimodal therapy]

MÉSZÁROS Edina, LANDHERR László

[Breast cancer is the most frequently diagnosed cancer and leading cause of cancer death in women worldwide. Approxi­mately two-thirds of cases are potencially sensitive to endocrine therapy. Fulvestrant is a selective estrogen receptor downregulator indicated for the treatment of postmenopausal women with estrogen receptor positive, locally advanced or metastatic breast cancer for disease relapse on or after adjuvant antiestrogen therapy, or disease progression on therapy with antiestrogen. We are reporting here a nearly ten-years-long sucessful combination of multiple treatment lines of anti-estrogen treatment, chemotherapy and radiotherapy in a case of a patient with hormone receptor positive, HER2 negative breast cancer with pulmonary metastases.]

Lege Artis Medicinae

SEPTEMBER 20, 2017

[Effective fulvestrant treatment of indolent breast cancer in a patient with low compliance - a case report]

HÓDI Veronika

[In the explosive development of treatment of oncological patients, there are still patients who are not always cooperative even in their own treatment. The case report exemplifies that even in this case the endocrine treatment has its place in the hormone receptor positive breast cancer. ]

Lege Artis Medicinae

JULY 20, 2017

[Fulvestrant: long-term survival and quality of life in a patient with hormone receptor-positive advanced breast cancer]

PINTÉR Tamás

[INTRODUCTION - There are lot of evidence showing the efficacy of fulvestrant therapy in HER-2 negative, HR-positive advanced metastatic breast cancer. CASE REPORT - A 75-year-old female had a mastectomy, followed by series of adjuvant and radiotherapy about 30 years ago. Later cutan metastases were removed several times. The endocrine therapy had to be stopped because of intolerance. An ER, PR positive, HER-2 negative cutan metastasis was resected 7 years ago for the last time. During regular checkup, 5 years ago pulmonary nodule and bone metastases were found, - PET-CT disclosed multiple metastatic lymph nodes as well. We started fulvestrant and bisphosphonate therapy. Thereafter, as imaging revealed, the malignant disease has stabilized, the patient has a good performance status, her musculo-skeletal pain has a presumably degenerative origin. DISCUSSION - Reported case corroborates the potential efficacy of fulvestrant and ibandronate in hormone sensitive breast cancer with good prognostic markers, even in the case of metastases in soft tissue and bone. This case supports the data, that in patients with not progressive bone metastases the frequency of administration of parenteral bisphosphonates may be reduced to every 3 months. Advanced metastatic breast cancer may be converted to a chronic disease in properly selected cases, and it could mean long-term survival with a good quality of life.]

Lege Artis Medicinae

MAY 20, 2017

[Fulvestrant treatment of breast cancer in a patient with severe comorbidities - a case report]

BÁNHEGYI Róbert János, NAGY Ágnes Krisztina, LIPPAI Zsuzsanna, FÜLÖP Ferenc, RAJTÁR Mária, PIKÓ Béla

[Today, despite the increasing number of targeted and immunotherapeutic agents in oncology, the endocrine therapy is still an effective and manageable modality with acceptable safety profile in the treatment of hormone receptor positive breast cancer, especially in patients with multiple severe comorbidities. We present a case of successful treatment with fulvestrant of a woman with breast cancer and non-Hodgkin lymphoma, diabetes and heart failure, that emphasizes the need of personalized treatment. ]