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How would you manage a left sided triple negative breast cancer with a concurrent left sided locally advanced non-small cell lung cancer?

The left breast cancer is an ER-negative, PR-negative, HER2-negative cT2N0 invasive ductal carcinoma, while the left lung primary is a cT2N1 squamous cell carcinoma. What is the appropriate approach and sequence of therapies in this case of synchronous primaries?
4 Answers
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Radiation Oncology · Washington University in St Louis
Answered on

The presentation of two primary cancers that carry serious prognoses is very challenging. There are many variables at play here that could alter the initial therapeutic approach and ongoing treatment. Assuming this patient has a reasonable KPS, PFTs, and can undergo surgery, one way to start is neoa...

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Medical Oncology · H Lee Moffitt Cancer Center, University of South Florida
Answered on · Updated on

This is a tough one to juggle as prolonging therapy for the TNBC could adversely affect the NSCLC or vice versa. If the patient is appropriate for it, I would attempt a platinum/taxane/aPD-1 for 4 cycles and assess response in the breast with MRI along with repeat imaging of chest. The most straight...

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Medical Oncology · University of Utah Huntsman Cancer Institute
Answered on

I would treat her according to the KEYNOTE-522 trial with carboplatin, taxane, and pembrolizumab. This would be excellent therapy for the breast cancer, and carboplatin/Taxol/immunotherapy would also be a standard regimen for squamous cell carcinoma of the lung (though typically an immunotherapeutic...

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Medical Oncology · Medical College of Wisconsin
Answered on

Agree, this is a tough case. Treating two separate histologies and two separate organs is very challenging. I am guessing that metastases have been ruled out in either case and we are treating two primaries at the same time. Given that both are aggressive pathologies, our goal is cure in this contex...

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