How would you manage a young patient with newly recurrent metastatic triple negative breast cancer less than a year after completing adjuvant chemotherapy and worsening liver function due to intrahepatic disease?
Patient completed adjuvant AC-T 8 months prior to recurrence. BRCA negative, foundation medicine NGS pending.
Answer from: Medical Oncologist at Academic Institution
Since she has a DFI less than 1 year from last taxane exposure, I would consider her taxane resistant. In general, I try to do carboplatin/gemcitabine, especially if the LFTs are abnormal. If her PDL1 is positive, you can try to add pembrolizumab similar to the KEYNOTE355 regimen. Following this oth...
Answer from: Medical Oncologist at Academic Institution
The choice of the regimen depends on the extent of the abnormalities of LFT, and also there is a need for the speed of the timeframe of the LFT changes before one can decide the regimen. Nab-paclitaxel, vinca alkaloids, and eribulin will all need a dose adjustment if the LFT is going up. But i...