Successful Treatment with Hepatic Arterial Infusion Chemotherapy in a Breast Cancer Patient with Multiple Liver Metastases Who Declined Systemic Therapy

Abstract

Despite improvements in systemic medical therapy (ST), liver metastases (LMs) are a poor prognostic factor in metastatic breast cancer (MBC) patients. We describe a MBC patient with predominant LMs treated with hepatic arterial infusion chemotherapy (HAIC) who declined ST. Moreover, we assessed general health status during treatment using C-reactive protein (CRP)/albumin ratio (CAR) and peripheral platelet count × CRP multiplier (P-CRP), well-known indicators of systemic inflammatory response. A 64-year-old woman who underwent a total mastectomy with axillary lymph node dissection for an HR-positive, HER2-negative infiltrating ductal BC developed multiple liver, lung, lymph node, and bone metastases. She received ST including paclitaxel plus the anti-vascular endothelial growth factor antibody, bevacizumab, hormone therapy with high-dose toremifene, the oral 5-fluorouracil derivative, S-1, and eribulin. She then declined ST because of the toxicity or decreased treatment motivation thereof, and opted for HAIC with 5FU plus epirubicin followed by Taxane for 1 year and 1 month. Computed tomography revealed a partial response or stable disease in the liver and slow progression in other sites without symptoms or side effects and decreased CEA and CA15-3 levels. The CAR and P-CRP remained low. She survived for 1 year and 3 months after the start of HAIC. This case reveals that HAIC may be an option for advanced BC patients with LMs who cannot receive ST.