maytansine and Carcinoma--Ductal--Breast

Trastuzumab is a monoclonal antibody targeted against the Human Epidermal Growth Factor Receptor 2 (HER2) overexpressed in some breast cancer. This targeted therapy significantly improves the prognosis of these cancers. Recently an anti-HER2 antibodydrug conjugate was shaped in order to facilitate the targeted delivery of potent cytotoxic drug to cancer cells and to reduce resistance. This formulation, called trastuzumab emtansine (T-DM1), consists of the monoclonal antibody trastuzumab linked to a cytotoxic drug (a derivative of maytansine) via a chemical linker. Little is known about adverse reactions due to this new formulation. Herein we described the case of a woman suffering from a HER2-positive breast cancer, treated with trastuzumab for 30 months followed by T-DM1 monotherapy. After 12 months of T-DM1 treatment, a nodular regenerative hyperplasia confirmed by liver biopsy occurred. T-DM1 was stopped and medical imagery showed a resolution of the nodular regenerative hyperplasia. Unfortunately, hepatic metastasis progressed. Few cases of nodular regenerative hyperplasia induced by T-DM1 have been described so far. Further studies are needed to explore pathogenesis of nodular regenerative hyperplasia with this new antibody-drug conjugate treatment.

Topics: Ado-Trastuzumab Emtansine; Biopsy, Needle; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Follow-Up Studies; Humans; Hyperplasia; Immunohistochemistry; Liver Neoplasms; Magnetic Resonance Imaging; Maytansine; Middle Aged; Molecular Targeted Therapy; Receptor, ErbB-2; Risk Assessment; Trastuzumab; Withholding Treatment

Topics: Ado-Trastuzumab Emtansine; Antibodies, Monoclonal, Humanized; Carcinoma, Ductal, Breast; Corneal Diseases; Diagnostic Techniques, Ophthalmological; Drug Monitoring; Epithelium, Corneal; Humans; Immunoconjugates; Maytansine; Mesothelioma, Malignant; Multiple Myeloma; Photophobia; Vision Disorders

Topics: Ado-Trastuzumab Emtansine; Adult; Antineoplastic Agents, Immunological; Breast Neoplasms; Carcinoma, Ductal, Breast; Epithelium, Corneal; Female; Humans; Maytansine; Ophthalmic Solutions; Receptor, ErbB-2; Trastuzumab; Treatment Outcome; Vision Disorders

Topics: Ado-Trastuzumab Emtansine; Aged; Antibodies, Monoclonal, Humanized; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Hyperplasia; Hypertension, Portal; Liver; Maytansine; Middle Aged; Trastuzumab

To report a case of atypical corneal lesions presumably induced by trastuzumab emtansine, an antibody-drug conjugate that is designed to selectively deliver cytotoxic agents to human epidermal growth factor receptor 2 (HER2)-positive breast cancer cells.. A 64-year-old Japanese woman developed bilateral corneal epithelial abnormalities that originated from the limbus. The corneal lesions covered the superior area in the right eye and both superior and inferior areas including the visual axis in the left eye. The patient had advanced ductal carcinoma of the left breast and had been receiving anticancer treatment with trastuzumab emtansine for 15 months. After switching the chemotherapy from trastuzumab emtansine monotherapy to the combination of docetaxel, trastuzumab, and pertuzumab, the abnormal corneal lesions showed gradual improvement.. As corneal epithelial cells express human epidermal growth factor receptor 2 under normal conditions, such cells may also be targeted by trastuzumab emtansine and lead to corneal epithelial lesions.

Topics: Ado-Trastuzumab Emtansine; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Carcinoma, Ductal, Breast; Corneal Diseases; Drug Substitution; Epithelium, Corneal; Female; Humans; Maytansine; Middle Aged; Receptor, ErbB-2; Trastuzumab; Visual Acuity