Effect of Lipodox in combination with bevacizumab in a patient with a metastatic malignant phyllodes breast tumor: A case report

Abstract

A 76-year-old female patient with a malignant phyllodes tumor underwent modified radical mastectomy and wide excision. Multiple nodules were observed in the operated wound area. Positron emission tomography-computed tomography (PET-CT) revealed recurrent disease in the left breast, the adjacent left third rib, the left internal mammary region and the left ilium. A novel formulation of bevacizumab (5 mg/m2, first day) in combination with liposomal doxorubicin (Lipodox, 30 mg/m2, second day) was administered for 3 cycles every 2 weeks, and subsequently wide excision was performed. Lipodox (40 mg/m2) was administered for 3 cycles every 3 weeks, starting 4 weeks after the surgery. Follow-up whole body PET-CT scanning, 3 and 6 months later, indicated no sign of residual hypermetabolic malignancy. Malignant phyllodes tumors do not usually respond to chemotherapy or radiotherapy. In the present case report, a novel formulation of bevacizumab in combination with Lipodox was administered as neoadjuvant chemotherapy in a patient with a malignant phyllodes tumor and preoperative tumor shrinkage was achieved, resulting in clear resection margins.

Metastatic and Malignant Phyllodes Tumors of the Breast: An Update for Current Management

“…One case study demonstrated combining neoadjuvant liposomal doxorubicin and bevacizumab allowed adequate tumor shrinkage for resection and metastasectomy. 52 A second case report demonstrated that liposomal doxorubicin in conjunction with albumin-bound paclitaxel, cisplatin, and accelerated radiotherapy led to the patient being disease-free after two years of follow-up. 53…”

Olaratumab administered in two cases of phyllodes tumour of the breast: end of the beginning?

“…Small series and single cases of metastatic breast phyllodes tumours published report the use of doxorubicin-based systemic chemotherapy 13–16. Liposomal doxorubicin in combination with bevacizumab has been reported in one case 17. In an Indian report, epirubicin with ifosfamide was administered to four patients 18.…”