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Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • Triple negative • Moffitt Cancer Center • NCI-CCC Breast Tumor Board Question
How would you manage a patient who develops pleural and skin metastases shortly after completing neoadjuvant ddAC-T and surgery for a locally advanced triple negative breast cancer?
PD-L1 is low and she has residual neuropathy from neoadjuvant paclitaxel.
Answer from: Medical Oncologist at Academic Institution
Any solid tumor refractory to frontline chemotherapy has three pathways moving forward:1. Clinical trial2. NGS on tissue to identify FDA approved targets (specifically BRCA in this case)3. Standard second line therapies.Under option 3: For PD-L1 > or = 1%, the combination of atezolizumab and nab-...
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Answer from: Medical Oncologist at Academic Institution
With pleural disease, this is definitively distant mets. I think this is important as sometimes those with local skin only recurrence can still be treated with curative intent. I would agree with testing for BRCA mutation for PARP inhibitor, genomic testing, and looking for clinical trials. If none ...
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Medical Oncologist at Ohio State University
I agree that radiation therapy should be the next ...
I agree that radiation therapy should be the next ...
Answer from: Medical Oncologist at Community Practice
Do you think adding neoadjuvant immunotherapy would’ve helped? Thanks.
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Medical Oncologist at University of Alabama School of Medicine
That is a very good observation. Neoadjuvant pembr...
That is a very good observation. Neoadjuvant pembr...
Medical Oncologist at Newport Breast Care
Most of those patients were PDL1+. This patient ha...
Most of those patients were PDL1+. This patient ha...
Answer from: Medical Oncologist at Academic Institution
I agree with the above pathways. I would also like to add that if post-operative radiation has not yet been done, this would be a next viable option.
Answer from: Medical Oncologist at Community Practice
Capecitabine is a good option unless they are BRCA mutation positive, then I'd consider a PARP inhibitor.
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Medical Oncologist at University of Utah Huntsman Cancer Institute
I agree. Since this is an incurable disease, the g...
I agree. Since this is an incurable disease, the g...