Oncotarget

Case Reports:

Response to apatinib in chemotherapy-failed advanced spindle cell breast carcinoma

Na Zhou, Congmin Liu, Helei Hou, Chuantao Zhang, Dong Liu, Guanqun Wang, Kewei Liu, Jingjuan Zhu, Hongying Lv, TianjJun Li and Xiaochun Zhang _

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Oncotarget. 2016; 7:72373-72379. https://doi.org/10.18632/oncotarget.12568

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Abstract

Na Zhou1, Congmin Liu2, Helei Hou1, Chuantao Zhang1, Dong Liu1, Guanqun Wang3, Kewei Liu1, Jingjuan Zhu1, Hongying Lv1, Tianjun Li1 and Xiaochun Zhang1

1 Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, China

2 Department of Oncology, Qingdao Municipal Hospital, Qingdao, China

3 Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China

Correspondence to:

Xiaochun Zhang, email:

Keywords: spindle cell carcinoma; Apatinib; VEGFR; targeted therapy

Received: July 04, 2016 Accepted: October 03, 2016 Published: October 11, 2016

Abstract

Spindle cell carcinoma of the breast is a rare subtype of metaplastic carcinoma, and no effective chemotherapy special for metaplastic carcinoma exists until now. As spindle cell carcinomas of the breast are typically “Triple Negative”, endocrine therapy and molecular therapy targeted to Her2 might not be favorable, resulting in poor prognosis. Apatinib is currently being tested in patients with breast or lung cancers. Here we report a successful case using Apatinib to treat spindle cell carcinoma of breast.

A 52- year- old woman presented with a gradually enlarged lump in left breast, which was revealed to be a triple-negative spindle cell carcinoma, underwent a modified radical mastectomy. After the first line chemotherapy with Cyclophosphamide and Epirubicin, multiple metastases in bilateral lung and left anterior thoracic wall appeared. After disease progressed with therapy of Bevacizumab combined with Albumin-bound Paclitaxel and Cisplatin, we treated the patient with Apatinib according to her VEGFR expression, which showed nearly complete response and controllable and tolerated side effects. Next-generation sequencing analysis of the tumor specimen and real time ctDNA was performed to observe the mutated gene numbers matched with therapeutic effect. The present case can help to provide a new and effective therapy strategy to treat advanced spindle cell carcinoma.


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