PMC9659609_01
Evaluation of the therapeutic effect after chemotherapy. (A) A frontal view of the patient first presenting with a red and swollen left-side breast; (B) a frontal view of the redness and swelling of the patient's left breast decreasing obviously after six cycles of chemotherapy; (C) a frontal view of the patient completing 10 cycles of chemotherapy prior to a planned mastectomy; (D) a frontal view of the patient after bilateral mastectomy and local rotation skin flap grafting.
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Examination revealed 20 * 15 cm redness and swelling in the left breast and 4 * 3 cm mass in the upper quadrant of the right breast ( Figure 1A ). After six cycles of chemotherapy, the tumor size was reduced obviously ( Figure 1B ), but the drop in platelet count was also significant. Figure 2B ). Finally, to improve her quality of life, bilateral mastectomy and local rotation skin flap grafting were performed ( Figures 1C, D ).
PET/CT images evaluating the changes in breast masses and metastatic lymph nodes during treatment in case 1. (A) PET/CT images showing intense FDG uptake in the bilateral breast, bilateral axilla, left clavicular area, and left upper mediastinum at the time of initial diagnosis; (B) PET/CT images showing that areas of high FDG uptake in the breast and lymph nodes were significantly reduced after 10 cycles of chemotherapy.
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Furthermore, positron emission tomography/computed tomography (PET/CT) showed multiple lymph node metastases in the bilateral axilla, left clavicular area, and left upper mediastinum, and her final TNM stage was T4N3M1 ( Figure 2A ). Figure 3  and  Figure S2  (details are available in  Supplementary Material   Table S3 ). Finally, compared with the other treatments, the albumin paclitaxel (125 mg/m2) plus carboplatin (AUC = 2) d1, 8, 1/21d regimen showed a higher killing rate of the tumor cells (47%) and was selected. Figure 2B ). Finally, to improve her quality of life, bilateral mastectomy and local rotation skin flap grafting were performed ( Figures 1C, D ).
The drug sensitivity results of the PTC model for individualized treatment in case 1. (A) Comparison of trastuzumab before and after dosing; (B) comparison of epirubicin + cyclophosphamide before and after dosing; (C) comparison of vinorelbine + capecitabine before and after dosing; (D) comparison of albumin paclitaxel + capecitabine before and after dosing; (E) comparison of albumin paclitaxel + carboplatin before and after dosing; (F) negative control (NC) group.
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The PTC model was used for drug sensitivity screening ( Figure 4  and  Figure S3 ; details are available in  Supplementary Material   Table S4 ). The PTH (albumin paclitaxel 260 mg/m2 d1, trastuzumab 8 mg/kg d1 followed by 6 mg/kg d1, and pertuzumab 840 mg d1 followed by 420 mg d1, 1/21d) regimen showed a better tumor cell killing rate of 70% and was finally selected.
PMC9659609_02
The drug sensitivity results of the PTC model for individualized treatment in case 1. (A) Comparison of trastuzumab before and after dosing; (B) comparison of epirubicin + cyclophosphamide before and after dosing; (C) comparison of vinorelbine + capecitabine before and after dosing; (D) comparison of albumin paclitaxel + capecitabine before and after dosing; (E) comparison of albumin paclitaxel + carboplatin before and after dosing; (F) negative control (NC) group.
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The PTC model was used for drug sensitivity screening ( Figure 4  and  Figure S3 ; details are available in  Supplementary Material   Table S4 ). The PTH (albumin paclitaxel 260 mg/m2 d1, trastuzumab 8 mg/kg d1 followed by 6 mg/kg d1, and pertuzumab 840 mg d1 followed by 420 mg d1, 1/21d) regimen showed a better tumor cell killing rate of 70% and was finally selected.
The drug sensitivity results of the PTC model for individualized treatment in case 2. (A) Comparison of albumin paclitaxel + capecitabine + trastuzumab before and after dosing; (B) comparison of albumin paclitaxel + carboplatin + trastuzumab before and after dosing; (C) comparison of albumin paclitaxel + carboplatin before and after dosing; (D) comparison of pyrotinib + capecitabine before and after dosing; (E) comparison of epirubicin before and after dosing; (F) comparison of albumin paclitaxel + trastuzumab + pertuzumab before and after dosing; (G) negative control (NC) group.
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The PTC model was used for drug sensitivity screening ( Figure S4 ), and the results indicated that anti-HER2 therapy was effective.
PMC9659609_03
The drug sensitivity results of the PTC model for individualized treatment in case 2. (A) Comparison of albumin paclitaxel + capecitabine + trastuzumab before and after dosing; (B) comparison of albumin paclitaxel + carboplatin + trastuzumab before and after dosing; (C) comparison of albumin paclitaxel + carboplatin before and after dosing; (D) comparison of pyrotinib + capecitabine before and after dosing; (E) comparison of epirubicin before and after dosing; (F) comparison of albumin paclitaxel + trastuzumab + pertuzumab before and after dosing; (G) negative control (NC) group.
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The PTC model was used for drug sensitivity screening ( Figure S4 ), and the results indicated that anti-HER2 therapy was effective.
PMC9659609_04