内容紹介
Successful Ventilator Weaning by Trastuzumab in a HER2-Positive Breast Cancer Patient with Multiple Lung Metastases
Summary
We report a case of breast cancer with severe respiratory dysfunction due to multiple lung metastases, which was recovered by treatment with weekly trastuzumab administration. A 47-year-old woman with breast cancer had received a folk remedy from a general practitioner for 4 years. However, she was delivered to a hospital because of severe dyspnea, and intubation was found to be needed and performed. She was diagnosed with left breast cancer with skin and pleural wall invasion, and multiple lung metastases. Pathological examination showed invasive ductal carcinoma which was ER-postive, PgR-negative, and HER2-postive. After transfer to our hospital, treatment with trastuzumab(4 mg/kg/weekly for the first course, and 2 mg/kg/weekly thereafter)was administered. Respiratory function improved gradually, and ventilator weaning was successful at 53 days after trastuzumab administration. CT examination also showed a remarkable reduction of lung and lymph node metastases and pleural effusion. She was discharged from our hospital 80 days after treatment, and her treatment with trastuzumab and capecitabine has been ongoing at an outpatient clinic.
要旨
乳癌多発肺転移による呼吸不全のため人工呼吸器管理を要していたが,trastuzumab単独療法により人工呼吸器管理を脱し,外来通院可能となった1例を経験した。症例は47歳,女性。左乳癌にて4年間,開業医で民間療法を受けていたが,徐々に呼吸状態が悪化し,救急搬送された市民病院で人工呼吸器管理となった。同病院にて胸壁・皮膚浸潤を伴う左乳癌,多発肺転移と診断された。組織診ではinvasive ductal carcinoma,nuclear grade 1(2+1),ER(+),PgR(-),HER2(3+)であった。当院に転院後,trastuzumab単独療法(初回4 mg/kg/weekly,2回目以降2 mg/kg/weekly)を開始したところ徐々に呼吸状態は改善し,治療開始より53日後に人工呼吸器を離脱できた。CT上,肺転移やリンパ節転移は残存しているものの著明に縮小し,胸水も減少していた。trastuzumab単剤を計12回投与し,治療開始より80日目に退院した。治療開始から約2年半経過した現在も,外来にてtrastuzumabと化学療法剤併用療法を継続中である。
目次
Summary
We report a case of breast cancer with severe respiratory dysfunction due to multiple lung metastases, which was recovered by treatment with weekly trastuzumab administration. A 47-year-old woman with breast cancer had received a folk remedy from a general practitioner for 4 years. However, she was delivered to a hospital because of severe dyspnea, and intubation was found to be needed and performed. She was diagnosed with left breast cancer with skin and pleural wall invasion, and multiple lung metastases. Pathological examination showed invasive ductal carcinoma which was ER-postive, PgR-negative, and HER2-postive. After transfer to our hospital, treatment with trastuzumab(4 mg/kg/weekly for the first course, and 2 mg/kg/weekly thereafter)was administered. Respiratory function improved gradually, and ventilator weaning was successful at 53 days after trastuzumab administration. CT examination also showed a remarkable reduction of lung and lymph node metastases and pleural effusion. She was discharged from our hospital 80 days after treatment, and her treatment with trastuzumab and capecitabine has been ongoing at an outpatient clinic.
要旨
乳癌多発肺転移による呼吸不全のため人工呼吸器管理を要していたが,trastuzumab単独療法により人工呼吸器管理を脱し,外来通院可能となった1例を経験した。症例は47歳,女性。左乳癌にて4年間,開業医で民間療法を受けていたが,徐々に呼吸状態が悪化し,救急搬送された市民病院で人工呼吸器管理となった。同病院にて胸壁・皮膚浸潤を伴う左乳癌,多発肺転移と診断された。組織診ではinvasive ductal carcinoma,nuclear grade 1(2+1),ER(+),PgR(-),HER2(3+)であった。当院に転院後,trastuzumab単独療法(初回4 mg/kg/weekly,2回目以降2 mg/kg/weekly)を開始したところ徐々に呼吸状態は改善し,治療開始より53日後に人工呼吸器を離脱できた。CT上,肺転移やリンパ節転移は残存しているものの著明に縮小し,胸水も減少していた。trastuzumab単剤を計12回投与し,治療開始より80日目に退院した。治療開始から約2年半経過した現在も,外来にてtrastuzumabと化学療法剤併用療法を継続中である。