Bilateral Breast Cancers Followed by Metastatic Disease and Long Eribulin Treatment

What happened, in summary

A 58-year-old woman was diagnosed in 2006 with a large left-breast invasive ductal carcinoma. The tumor was ER 90%, PgR 75% and HER2 FISH not amplified. She received 3 cycles of neoadjuvant FEC chemotherapy, underwent left radical mastectomy with axillary dissection, then completed 3 more FEC cycles and started anastrozole. In 2009, a separate cancer was found in the right breast. That tumor was also invasive ductal carcinoma but had a different profile, including ER 90%, PgR 90% and HER2 1+. She underwent right radical mastectomy with sentinel-node biopsy, followed by 6 cycles of CMF and tamoxifen. In 2012, metastatic disease appeared in the lungs. Paclitaxel plus bevacizumab produced a partial response over 14 cycles. Later lung and pleural progression was treated with vinorelbine. By 2015, liver lesions had also appeared, and she began eribulin. The treatment improved pain and breathing, and after 21 cycles the liver metastases had completely responded while lung disease remained in partial response. In January 2017, new pelvic bone metastases led to discontinuation of eribulin. She then received radiation to the pelvis and started fulvestrant, which was still ongoing at the most recent follow-up.