Aman Chauhan, MD, discusses combining intratumoral Seneca Valley virus (SVV-001) with ipilimumab and nivolumab in neuroendocrine cancer.
|Videos|March 31, 2020
A 54-Year-Old Woman With Stage 2 HER2+ Breast Cancer
A 54-Year-Old Woman With Stage 2 HER2+ Breast Cancer
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Case: A 54-Year-Old Woman With Stage 2HER2+ Breast Cancer
Initial presentation
- A 54-year-old, postmenopausal woman presented with a painless palpable mass on the right upper outer quadrant of her right breast
- PMH/SH: unremarkable, no family history of cancer
- PE: ~ 4-cm palpable right breast mass, clinically node negative, no visible sink involvement
Clinical workup
- Labs: WNL
- Ultrasound showed a right breast mass, and two axillary lymph nodes
- Mammogram confirmed a rightsided, poorly defined speculated 4.2-cm mass
- PET/CT showed increased uptake in the right breast diffusely, with 2 FDGavid axillary lymph node involvement; no evidence of distant metastases
- Ultrasoundguided FNA biopsy of the breast mass confirmed grade 3 infiltrative ductal carcinoma
- Hormone receptor/HER2 Status:HER2+:3+ by IHC,80%ER+, PR-
- Stage T2N1M0; ECOG PS 0
Treatment and Follow-Up
- The patient was started on preoperative docetaxel + carboplatin + trastuzumab + pertuzumab (TCHP), and pegfilgrastim every 3 weeks for 6 cycles;
- Achieved clinical complete response
- She underwent right mastectomy; residual disease: 1 positive axillary lymph node, and 1-cm RD in the right breast; 4 sentinel lymph nodes removed, 1 positive for disease; she also received post mastectomy radiation therapy of her chest wall and regional lymphatics
- She was started on trastuzumab emtansine every 3 weeks for 14 cycles + aromatase inhibitor PMRT + letrozole planned for 10 years
- Extended adjuvant neratinib was initiated
- Week 1: 160 mg (4 tablets) PO qDay; week 2: 200 mg (5 tablets) PO qDay; week 3: 240 mg (6 tablets) PO qDay for 1 year
- IV zoledronic acid every 6 months was added to her regimen for 3-5 years
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