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Case Report
Concurrent use of fam-trastuzumab-deruxtecan-nxki and larotrectinib in metastatic breast cancer: A case report
1 North Houston Cancer Clinics, Huntsville, TX, USA
2 Sam Houston State University College of Osteopathic Medicine, Conroe, TX, USA
Address correspondence to:
Aryana Pourmotamed
North Houston Cancer Clinics, Huntsville, TX,
USA
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Article ID: 100129Z10HT2024
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Tiwari H, Pourmotamed A, Crocker C, Abbasi E. Concurrent use of fam-trastuzumab-deruxtecan-nxki and larotrectinib in metastatic breast cancer: A case report. J Case Rep Images Oncology 2024;10(1):13–16.ABSTRACT
A 60-year-old female presented in 2010 with left breast invasive lobular carcinoma, estrogen receptor (ER)+ (98%), progesterone receptor (PR)+ (98%), Her2 (2+), Ki67 (8%), Stage IIIC, T2 N3. She had lumpectomy, adjuvant chemo and radiation, took anastrozole until July 2019 when she had metastasis to bone. She started on palbociclib and fulvestrant. Imaging showed minimal improvement. In March 2022, her bone pain worsened and blood counts dropped and became transfusion dependent, bone marrow biopsy showed breast cancer metastases, ER+ (35%), PR−, Her2 (2+). PDL1 was negative, NTRK 1 was positive. She started on larotrectinib for her NTRK1 mutation, which showed some improvement and added fam-trastuzumab-deruxtecan-nxki for her Her2neu weekly positive, resulting in normalization of her blood counts. She has been on this combination which has never been reported, for over a year and has remained in remission with no significant toxicity. Targeting these two mutations simultaneously with possible additive effect can open some new trial ideas.
Keywords: Breast cancer leukemia, Breast cancer metastasis, Fam-trastuzumab-deruxtecan-nxki, Larotrectinib, Neurotrophic tyrosine receptor kinase (NTRK), Next-generation sequencing (NGS), Targetable mutations
SUPPORTING INFORMATION
Author Contributions
Hrishita Tiwari - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aryana Pourmotamed - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Caroline Crocker - Drafting the article, Final approval of the version to be published
Elham Abbasi - Interpretation of data, Drafting the article, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Hrishita Tiwari et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
