PMC4322880_01
Lung (A), liver (B), bone (C), and brain (D, E) metastases before start of nab-paclitaxel/trastuzumab treatment.. Abbreviation: nab, nanoparticle albumin-bound.
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A CT scan in September 2012 showed extensive progressive disease with appearance of new brain, liver, bone, and lung metastases (Figure 1).
Lung (A), Liver (B), Bone (C) and Brain (D) lesions after four courses of nab-paclitaxel/trastuzumab combination.. Abbreviation: nab, nanoparticle albumin-bound.
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Four courses of nab-paclitaxel/trastuzumab therapy were delivered, with evidence of a partial response in the lung lesion, with substantial stable disease (SD) in the liver and bone metastases and a minimal response in the brain nodules (Figure 2).
Lung (A), Liver (B), Bone (C) and Brain (D) lesions after nine courses of nab-paclitaxel/trastuzumab combination.. Abbreviation: nab, nanoparticle albumin-bound.
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Hence, she continued treatment for up to 14 cycles with the same schedule with substantial stable disease (Figure 3) and minimal neurological treatment-related toxicities.
Timeline of patient's diagnosis and treatments.. Abbreviations: BMs, brain metastasis; CHT, chemotherapy; CNS, central nervous system; FEC, fluouracil, epirubicin, and cyclophosphamide; HER, human epidermal growth factor receptor; PD, progressive disease; SRS, stereotactic radiosurgery; nab, nanoparticle albumin-bound; LHRH, luteinizing hormone-releasing hormone; RT, radiotherapy; WBRT, whole-brain radiotherapy.
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A complete list of all the patient's treatments is reported in Figure 4.