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Long-term complete response to intrathecal trastuzumab in a patient with leptomeningeal carcinomatosis due to her2- overexpressing breast cancer: Case report.

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Date

2020

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García, Francisco José Valdivia
Carrión, Natalia Palazón
de la Cruz-Merino, Luis

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Leptomeningeal dissemination due to HER2-overexpressing breast cancer is a rare and hard to treat complication with short-term dismal prognosis. A 34-year-old female previously treated because of HER2+ breast cancer is admitted to the Neurology Department in December 2016 due to sensory-motor neurological semiology. A wide set of diagnostic tests is performed and finally cytologic findings after repeated CSF confirm leptomeningeal infiltration by breast carcinoma (panCK+, GATA3+). Weekly intrathecal triple therapy with methotrexate, cytarabine and hydrocortisone plus trastuzumab is carried out during 4 months. Clinical and pathological response that lasts more than 24 months. Leptomeningeal carcinomatosis is an oncological situation where conventional therapies have limited activity. In HER2+ advanced breast cancer patients, intrathecal therapy with anti-HER2 therapy (trastuzumab) is feasible and may reach long-term disease control, especially in cases of low-tumor burden.

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Adult
Antineoplastic Agents, Immunological
Breast Neoplasms
Carcinoma, Ductal
Female
Humans
Meningeal Carcinomatosis
Pregnancy
Pregnancy Complications, Neoplastic
Receptor, ErbB-2
Trastuzumab

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