Key result
Neoadjuvant THP without dose adjustment was safe and effective, leading to uneventful surgery in 1 HER-2 positive breast cancer patient with chronic renal failure.
Why the study?
Chronic renal failure reduces drug excretion and increases toxicity, leaving few reports on docetaxel, trastuzumab, and pertuzumab as neoadjuvant therapy in breast cancer patients with chronic renal failure.
Is the THP neoadjuvant regimen safe and effective for HER-2 positive breast cancer patients with chronic renal failure?
Case Report (n=1)
Is the THP neoadjuvant regimen safe and effective for HER-2 positive breast cancer patients with chronic renal failure?
The THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with chronic renal failure.
May support THP neoadjuvant use in select breast cancer patients with CRF; hypothesis-generating and requires prospective validation.
BACKGROUND: Studies have shown that patients with chronic renal failure (CRF) are more likely to suffer from breast cancer and other malignant tumors. To our knowledge, CRF can reduce drug excretion, thereby increase drug exposure and lead to increased toxicity, which will limit drug treatment and lead to tumor progression. Currently, there are few successful reports on the combination of docetaxel, trastuzumab, and pertuzumab (THP) as a neoadjuvant treatment regimen for breast cancer patients with CRF. CASE SUMMARY: We report a breast cancer (cT2N2M0, Her-2+/HR-) patient with CRF. It was a clinical stage IIIA tumor on the left breast. The patient had suffered from uremia for 2 years, and her heart function was normal. Based on the pathological type, molecular type, and clinical stage of breast cancer, and the patient's renal function, the clinician analyzed the pharmacological and pharmacokinetic characteristics of the antitumor drugs after consulting the relevant literature, and prescribed the neoadjuvant regimen of THP (docetaxel 80 mg/m², trastuzumab 8 mg/kg for the first dose, and 6 mg/kg for the maintenance dose with pertuzumab 840 mg for the first dose and 420 mg for the maintenance dose), once every 3 wk, for a total of 6 courses. The neoadjuvant treatment had a good effect, and the patient then underwent surgery which was uneventful. CONCLUSION: CRF is not a contraindication for systemic treatment and surgery of breast cancer. The THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with CRF.
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Cai et al. (2021) conducted a case report in Breast cancer with chronic renal failure (n=1). THP (docetaxel, trastuzumab, and pertuzumab) was evaluated on Treatment effect and surgical outcome. Neoadjuvant THP without dose adjustment was safe and effective, leading to uneventful surgery in 1 HER-2 positive breast cancer patient with chronic renal failure.
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