Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10345
Peer-review started: July 8, 2021
First decision: August 18, 2021
Revised: September 5, 2021
Accepted: September 22, 2021
Article in press: September 22, 2021
Published online: November 26, 2021
Processing time: 136 Days and 22.2 Hours
Studies have shown that patients with chronic renal failure (CRF) are more likely to suffer from breast cancer and other malignant tumors. To our knowledge, CRF can reduce drug excretion, thereby increase drug exposure and lead to increased toxicity, which will limit drug treatment and lead to tumor progression. Currently, there are few successful reports on the combination of docetaxel, trastuzumab, and pertuzumab (THP) as a neoadjuvant treatment regimen for breast cancer patients with CRF.
We report a breast cancer (cT2N2M0, Her-2+/HR-) patient with CRF. It was a clinical stage IIIA tumor on the left breast. The patient had suffered from uremia for 2 years, and her heart function was normal. Based on the pathological type, molecular type, and clinical stage of breast cancer, and the patient’s renal function, the clinician analyzed the pharmacological and pharmacokinetic characteristics of the antitumor drugs after consulting the relevant literature, and prescribed the neoadjuvant regimen of THP (docetaxel 80 mg/m², trastuzumab 8 mg/kg for the first dose, and 6 mg/kg for the maintenance dose with pertuzumab 840 mg for the first dose and 420 mg for the maintenance dose), once every 3 wk, for a total of 6 courses. The neoadjuvant treatment had a good effect, and the patient then underwent surgery which was uneventful.
CRF is not a contraindication for systemic treatment and surgery of breast cancer. The THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with CRF.
Core Tip: Renal failure is an important factor limiting the treatment of breast cancer because of the nephrotoxicity of anticancer drugs. There are few successful case reports of the combination of docetaxel, trastuzumab and pertuzumab (THP), especially pertuzumab, as a preoperative neoadjuvant treatment regimen for breast cancer patients with chronic renal failure (CRF) and few pharmacokinetic studies are available on renal failure in these patients. This report describes a breast cancer patient with CRF, which shows the safety of pertuzumab and effectiveness of the THP preoperative neoadjuvant treatment regimen.