What happened, in summary

A 53-year-old woman underwent right quadrantectomy and axillary lymph-node dissection in 1995 for a 1.8 cm grade 3 invasive ductal breast carcinoma. The tumor was ER 100%, PgR negative and HER2 negative, and 9 of 16 lymph nodes were involved. She received adriamycin followed by CMF, locoregional radiation, 5 years of tamoxifen and then 5 years of letrozole. In 2011, the cancer returned in lymph nodes and bone. Anastrozole produced a complete clinical and radiologic response until 2013, when disease progressed in lymph nodes, bone and liver. Fulvestrant produced a major partial response for about a year. Everolimus plus exemestane then produced an initial complete response before high-burden liver progression developed in 2015. Weekly paclitaxel produced an early partial response followed by liver progression. Capecitabine also produced a partial response before the cancer progressed again. She started eribulin in June 2016. The treatment was well tolerated and did not require dose reduction. Restaging CT scans showed partial responses after 3, 6, 9 and 12 cycles. At the most recent follow-up, eribulin was still ongoing, with continuing evidence that the metastatic disease was responding.