PI3K inhibitor provides durable response in metastatic metaplastic carcinoma of the breast: A hidden gem in the BELLE-4 study
Journal
Journal of the Formosan Medical Association
Journal Volume
118
Journal Issue
9
Pages
1333-1338
Date Issued
2019
Author(s)
Abstract
Purpose: Metaplastic carcinoma of the breast (MCB) is a rare cancer characterized by the histologic presence of two or more histological cell types originating from epithelial and mesenchymal stem cells. Patients with metastatic MCB have a low response rate to conventional chemotherapy and poor survival. Optimal treatment strategies for metastatic MCB are urgently needed. Methods: We retrospectively reviewed a patient who had enrolled in the phase II/III seamless study, BELLE-4 (NCT01572727). The patient's response to the study drug assessed by an investigator per protocol and clinical course were examined and compared with those of the main cohorts in the BELLE-4 study. Results: Our patient exhibited metastatic MCB and received systemic chemotherapy, paclitaxel (70 mg/m2/week) and buparlisib (80 mg/day), a pan-class I phosphatidylinositol-3 kinase (PI3K) inhibitor. The optimal response was a confirmed partial response for 17 months in total. During the compassionated use program period, the tumor regrew when buparlisib was stop because of toxicity, and responded to the treatment again after resumed the buparlisib treatment. The overall survival of the patient after the development of metastatic MCB was 42 months. She experienced grade 3 hyperglycemia similar to that observed in the main cohort. Conclusion: Buparlisib plus weekly paclitaxel might be a new treatment option for patients with metastatic MCB harboring a PIK3CA mutation. Additional prospective studies for investigating the efficacy of the proposed combination are warranted. ? 2018 Formosan Medical Association
SDGs
Other Subjects
buparlisib; cyclophosphamide; cytokeratin; paclitaxel; UFT; vimentin; aminopyridine derivative; antineoplastic agent; morpholine derivative; NVP-BKM120; paclitaxel; adjuvant radiotherapy; aged; Article; cancer combination chemotherapy; cancer growth; cancer patient; case report; computer assisted tomography; contrast enhancement; drug withdrawal; female; human; human epidermal growth factor receptor 2 positive breast cancer; hyperglycemia; lung metastasis; major clinical study; metaplastic carcinoma; metastatic breast cancer; multiple cycle treatment; overall survival; phase 2 clinical trial (topic); phase 3 clinical trial (topic); progression free survival; randomized controlled trial (topic); retrospective study; simple mastectomy; systemic therapy; thorax radiography; treatment duration; treatment response; triple negative breast cancer; very elderly; breast tumor; carcinoma; metaplasia; pathology; treatment outcome; x-ray computed tomography; Aged, 80 and over; Aminopyridines; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Carcinoma; Female; Humans; Metaplasia; Morpholines; Paclitaxel; Phosphoinositide-3 Kinase Inhibitors; Randomized Controlled Trials as Topic; Tomography, X-Ray Computed; Treatment Outcome
Publisher
Elsevier B.V.
Type
journal article