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?

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...

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 it can ...