Do immunotherapy help in stage 4 breast cancer?

Question

Hi doctor,

The first case of cancer was a stage 3 ER+ invasive cancer of the left breast. Now, it is in stage IV invasive lobular carcinoma, with results of ER positive, PR positive, and HER2 with equivocal recurrent cancer. The site of disease is present on the abdominal lymph nodes and omentum with ascites and pleural effusions.

Is the current treatment right?
Are there any other tests recommended that help find more information?
Any further recommendations required? Should we need to try clinical trials or immunotherapy?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I have gone through the attachment (attachment removed to protect patient identity). Yes, it is appropriate to use chemotherapy at this juncture. The HER2 (human epidermal growth factor receptor 2) result is mentioned as equivocal. So, please do a FISH test (fluorescence in situ hybridization) to find out whether it is positive or negative.

After chemotherapy, consider doing maintenance hormonal therapy. Immunotherapy in breast cancer is still in its infancy, and promising results are seen in triple-negative breast cancer. I will not suggest a clinical trial at this juncture.

I hope you find this helpful.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

1. Let us wait and see what FISH (fluorescence in situ hybridization) results show.

2. Genomic sequencing and testing are useful in adjuvant or curative settings to look at the efficacy of chemotherapy.

3. Immunotherapy is a new concept and has been explored in various cancers. To the best of my knowledge, triple-negative breast cancer is an area of promise.

4. There is no scientific backing for using immunotherapy in breast cancer in daily clinical practice for lobular carcinoma at this stage.

However, if you find ongoing trials, feel free to get enrolled.

I hope this helps.

Thank you.