Remission in Metastatic Breast Cancer Using Pegylated Irinotecan
Remission in Metastatic Breast Cancer Using Pegylated Irinotecan
Introduction Pegylated irinotecan NKTR-102 is a topoisomerase I inhibitor-polymer conjugate. This new formulation of irinotecan has been evaluated in a phase II clinical trial and is showing remarkable activity. To the best of our knowledge, this is the first case report of an impressive iterative response to pegylated irinotecan NKTR-102 in metastatic breast cancer.
Case presentation We report the case of a 49-year-old Caucasian woman diagnosed with metastatic luminal A breast cancer with initial bone followed by liver and bone marrow metastases, treated with three lines of hormonal therapy, targeted therapy and six lines of chemotherapy. She showed no major response to conventional treatment, whereas, the tumor shrinkage under pegylated irinotecan NKTR-102 was impressive, durable and iterative.
Conclusions Reintroduction of an active drug is a valid approach as illustrated by our case. The results of the current phase III trials of pegylated irinotecan NKTR-102 are eagerly awaited.
Metastatic breast cancer is an incurable disease. Systemic therapy aims to prolong disease control while preserving good quality of life. During past years, many drugs have been developed and have proven efficacy, leading to some prolongation of overall survival. The active search for new anticancer drugs continues while new formulations of the existing ones are also being pursued. Irinotecan, a topoisomerase I inhibitor and a major cytotoxic drug for some tumor types, has limited activity in breast cancer. Thus, it has been reformulated by pegylation, in order to reach a durable high concentration in tumor tissue, with the hope that its antitumor spectrum activity will be broadened. This new formulation, NKTR-102, has shown promising activity in phase II studies and it is currently being evaluated in phase III clinical trials. We report the case of a patient, enrolled in a clinical trial with pegylated irinotecan, who showed an impressive and prolonged response even after the drug's reintroduction.
Abstract and Introduction
Abstract
Introduction Pegylated irinotecan NKTR-102 is a topoisomerase I inhibitor-polymer conjugate. This new formulation of irinotecan has been evaluated in a phase II clinical trial and is showing remarkable activity. To the best of our knowledge, this is the first case report of an impressive iterative response to pegylated irinotecan NKTR-102 in metastatic breast cancer.
Case presentation We report the case of a 49-year-old Caucasian woman diagnosed with metastatic luminal A breast cancer with initial bone followed by liver and bone marrow metastases, treated with three lines of hormonal therapy, targeted therapy and six lines of chemotherapy. She showed no major response to conventional treatment, whereas, the tumor shrinkage under pegylated irinotecan NKTR-102 was impressive, durable and iterative.
Conclusions Reintroduction of an active drug is a valid approach as illustrated by our case. The results of the current phase III trials of pegylated irinotecan NKTR-102 are eagerly awaited.
Introduction
Metastatic breast cancer is an incurable disease. Systemic therapy aims to prolong disease control while preserving good quality of life. During past years, many drugs have been developed and have proven efficacy, leading to some prolongation of overall survival. The active search for new anticancer drugs continues while new formulations of the existing ones are also being pursued. Irinotecan, a topoisomerase I inhibitor and a major cytotoxic drug for some tumor types, has limited activity in breast cancer. Thus, it has been reformulated by pegylation, in order to reach a durable high concentration in tumor tissue, with the hope that its antitumor spectrum activity will be broadened. This new formulation, NKTR-102, has shown promising activity in phase II studies and it is currently being evaluated in phase III clinical trials. We report the case of a patient, enrolled in a clinical trial with pegylated irinotecan, who showed an impressive and prolonged response even after the drug's reintroduction.
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