A Case of Breast Cancer Associated with Multiple Bone Metastases Successfully Treated with Denosumab and Capecitabine

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The case is a 76-year-old woman, who consulted our hospital due to back pain and bilateral costalgia. She was diagnosed with multiple bone metastases of the right breast cancer upon close examinations. The result of a needle biopsy indicated a human epidermal growth factor receptor-2 (HER2) enriched type papillotubular carcinoma. Treatment due to trastuzumab was not suitable because of poor cardiac function, leading to the selection of a denosumab-administration regimen against systemic bone metastases in addition to capecitabine. Denosumab was subcutaneously injected in 120 mg doses every 4 weeks, and oral administration of capecitabine at 1,200 mg/day (administration for 3 weeks and 1 week drug withdrawal) was initiated from the second denosumab administration onwards. After initiation of the combination therapy of denosumab and capecitabine, the levels of tumor markers were gradually decreased, accordingly, the tumor size in the right breast was regressed. The patient’s general condition was also significantly improved. Few adverse events were recognized in combined therapy using denosumab and capecitabine, and it was believed to have high efficacy and tolerability in cases with poor performance status.

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