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Purpose <p>CDK4/6 inhibitors in combination with endocrine therapy are the standard of care for ER+/HER2 advanced breast cancer patients with good tolerability and durable control. The question of therapeutic de-escalation is a common one with no simple answer.</p> Methods <p>A clinical case was used to discuss the arguments in favour of therapeutic de-escalation.</p> Results <p>A 76-year-old woman was diagnosed with ER+ de novo MBC with liver metastases. She was treated with a combination of palbociclib and letrozole and had a complete metabolic response after 3 years of treatment with a good tolerability. After a synthesis of the data from the literature and in agreement with the patient, we decided to maintain the same systemic treatment without de-escalation.</p> Conclusion <p>Therapeutic de-escalation can be considered in the case of complete and durable remission with less aggressive disease.</p>

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Complete and Durable Remission in Metastatic Breast Cancer with Liver Metastases Using a Combination of Cyclin-Dependent Kinase 4/6 Inhibitor and Aromatase Inhibitor: What About Therapeutic De-Escalation?

  • 期刊论文

  • 发表日期：

    2025年1月8日

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  • Choukri Elm’hadi,
  • Meryem Zerrik,
  • Rachid Tanz

摘要

Purpose

CDK4/6 inhibitors in combination with endocrine therapy are the standard of care for ER+/HER2 advanced breast cancer patients with good tolerability and durable control. The question of therapeutic de-escalation is a common one with no simple answer.

Methods

A clinical case was used to discuss the arguments in favour of therapeutic de-escalation.

Results

A 76-year-old woman was diagnosed with ER+ de novo MBC with liver metastases. She was treated with a combination of palbociclib and letrozole and had a complete metabolic response after 3 years of treatment with a good tolerability. After a synthesis of the data from the literature and in agreement with the patient, we decided to maintain the same systemic treatment without de-escalation.

Conclusion

Therapeutic de-escalation can be considered in the case of complete and durable remission with less aggressive disease.