Metastatic breast cancer (MBC) entails an overall 5-year survival of approximately 25%. The choice of therapy is influenced by expression of the HER2 gene and hormone receptors, by a disease-free interval, and by age. The use of paclitaxel combined with gemcitabine (doublet protocol) has shown efficacy as first-line treatment for MBC in either initial or maintenance therapy when compared to monotherapy with paclitaxel. There is evidence showing that the doublet protocol is a good alternative to maintenance therapy in women under 50 years old. Nevertheless, there is a lack of information concerning individuals above that age. We report the case of an 81-year-old patient presenting with recurrence of MBC, with lung and skin metastases both positive for hormone receptor and negative for HER2. We implemented a therapy based on the combination of gemcitabine and paclitaxel for 12 cycles, when complete response was achieved. Currently, 16 months after this achievement, the patient is receiving maintenance treatment under the doublet protocol, presenting acceptable parameters of toxicity since the beginning of treatment, which shows satisfactory tolerability and management of chemotherapy in an elderly patient. We suggest that the maintenance treatment protocol with a doublet might be an alternative with a satisfactory response in patients with MBC.
INTRODUCTION: Serum glucose is commonly associated with a bad clinical prognosis in many diseases, including colorectal cancer (CRC). However, the real impact of glucose variation (GV) on the treatment and prognosis of CRC patients is unknown. Due to the absence of information, this study aimed to correlate GV and treatment response in advanced CRC. MATERIALS AND METHODS: Thirty-eight CRC patients with stage III and IV disease were studied. The selected ones were those who have had two consecutive computed-tomography scans and more than one serum glucose (SG) test between the CT scans, which left 19 people of the original group. RESULTS: The mean age of the 19 analyzed subjects was 58.6 years SD=18.26; CI 95% 50.9-71.0. Most of the patients were men (59%), with Wilt-Type KRAS mutation (63.2%), without metastasis (71%) and at a clinical stage III (73.3%). No statistically significant value was found (p=0.126) between GV and treatment response in advanced CRC patients. CONCLUSION: These findings cannot indicate a direct association between GV and treatment response in advanced CRC patient, but open space for evaluation of new methods of handling glucose variations in attempt to get a better understanding about how glucose may influence the CRC prognosis.
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