RESPON BAIK KOMBINASI CDK 4/6 INHIBITOR DAN AROMATASE INHIBITOR DENGAN RADIOTERAPI KONKUREN PADA KANKER PAYUDARA STADIUM LANJUT TIPE LUMINAL
Keywords:
breast cancer, lung metastasis, liver metastasis, pulmonary pleural effusion, radiotherapy, CDK 4/6 inhibitor, palbociclib, Aromatase inhibitor, letrozoleAbstract
Objectives : Advanced stage Luminal type breast cancer (Hormonal receptor positive, HER-2 negative) is often encountered with various complaints that incriminate the patient, as well as limited therapeutic options that can be offered to the patient.
Clinical Features : We present a 45-year-old female right-sided breast cancer patient admitted to our center with severe dyspnea owing to massive right lung pleural effusion, and extensive ulcer in the right breast with pain and active bleeding. Histopathology is invasive breast cancer no special type (NOS) WHO grade 3, strong ER (+), strong PR (+), Ki67 >20% and HER-2 (-). Staging is confirmed to be T4d N2 M1, with lung and liver metastasis.
Intervention and Outcomes : The patient underwent thorax-drain installation to evacuate the effusion fluid. She started to take oral CDK 4/6 inhibitor Palbociclib 125 mg OD (d1-21) together with Letrozole 2.5 mg OD. As the wound healing was not satisfactory after 2 cycles, then concurrent radiotherapy was being opted to treat the right breast for 60 Gy in 30 fractions. The response after radiotherapy was remarkable as the wound was significantly healed with minimal side effects.Conclusion : This case illustrates a possible synergistic effect of concurrent Radiotherapy with oral CDK 4/6 inhibitors and Aromatase inhibitors. Minimal side effects and a significant response was highlighted in this case.
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