Effectiveness of palbociclib plus letrozole as first line therapy of metastatic breast neuroendocrine carcinoma: A case report

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Introduction: Palbociclib plus endocrine therapy is the standard treatment of advanced luminal breast cancer. However, we lack data on its effectiveness in breast neuroendocrine carcinoma (NEC).

Aim(s): Investigating the efficacy of palbociclib in the treatment of metastatic neuroendocrine breast cancer.

Materials and methods: We present the case of a 57-year-old single female nurse without history, presented to our department of medical oncology with a left breast mass occupying the whole breast and adherent to the skin, with a fixed axillary lymphadenopathy of about 30 mm. She reported back pain as well. Core needle biopsy of the breast mass showed grade 2 NE breast carcinoma, with strong positivity of chromogranin A, synaptophysin and gata 3. Further analysis revealed ER positivity (100%), PR positivity (50%), negativity of HER-2 (0) and a Ki-67 index of 15%. Thoraco-abdomino-pelvic CT and bone scintigraphy revealed spinal and sternal metastasis, pulmonary lymphangitic carcinomatosis (PLC) and mediastinal and left axillar adenopathy. 68 Ga-DOTATOC PET/CT showed metastatic bone and lymph nodes as well as the primary site. Serum levels of CEA and CA 15-3 were elevated (CEA = 42.60 ng/ml, CA 15-3 = 39.38 U/ml). The patient was started on first-line therapy with letrozole plus palbociclib plus denosumab.

Conference:

Presenting Author:

Authors: Saidi M, Aris H, Elyebdri H, Ilham L,

Keywords: breast neuroendocrine carcinoma, CDK4/6 inhibitor, palbociclib, endocrine therapy,