High-dose fulvestrant as third-line endocrine therapy for breast cancer metastasis to the left kidney: A case report and literature review

Medicine (Baltimore). 2018 Jun;97(24):e11115. doi: 10.1097/MD.0000000000011115.

Abstract

Rationale: Endocrine therapy plays an important role in the treatment of patients with hormone receptor-positive breast cancer. Renal metastasis of breast cancer is rare in clinical practice.

Patient concerns: We present here a 54-year-old woman with breast cancer after first line chemotherapy and second line endocrinotherapy (i.e., toremifene & exemestane) failure.

Diagnoses: The patient was rarely diagnosed breast cancer metastasis to the kidney and a positive hormone status (ER and PR) but was negative for human epidermal factor receptor 2 (HER2).

Interventions: The patient was treated with a high dose of fulvestrant (SERD; 500 mg) by intramuscular injection once per month.

Outcomes: The patient's condition significantly improved as measured by a decrease in the renal and pulmonary masses; symptoms including dry cough and blood phlegm also improved.

Lessons: Endocrinotherapy with high-dose fulvestrant may provide benefits for patients with HR+/HER2- advanced breast cancer with renal metastasis after SERMs failure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Estradiol / administration & dosage
  • Estradiol / analogs & derivatives*
  • Female
  • Fulvestrant
  • Humans
  • Kidney / pathology
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / secondary*
  • Lung Neoplasms / secondary
  • Middle Aged
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents, Hormonal
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Fulvestrant
  • Estradiol