Lasting remission following multimodal treatment in a patient with metastatic breast cancer

Anticancer Drugs. 2005 Nov;16(10):1135-7. doi: 10.1097/01.cad.0000180122.24031.13.


We report on a lasting remission from multimodal treatment in a patient with hepatic metastasized breast cancer. After surgical removal of a singular hepatic metastasis, the patient underwent leukapheresis of peripheral blood mononuclear cell (PBMCs). For induction chemotherapy, the patient received 2 cycles of epirubicin and paclitaxel (ET). After 1 cycle of epirubicin and ifosfamide (EI), peripheral blood stem cells were harvested. After a final cycle of ET, the patient underwent high-dose chemotherapy (HDCT; thiotepa 600 mg/m/melphalan 180 mg/m) and autologous stem cell transplantation. Once reconstitution was achieved, PBMCs were reinfused followed by i.v. application of a trifunctional antibody (TrAb) with specificities anti-EpCAMxanti-CD3. TrAbs are able to simultaneously bind tumor cells, T cells, and additionally FcgammaR type I and III+accessory cells via their Fc region. Side-effects during treatment were hematotoxicity, mucositis and gastrointestinal toxicity. TrAb treatment resulted in intermittent fever, chills, elevated liver enzymes, systemic inflammatory response syndrome and pulmonary leakage. With a follow-up period of more than 8 years the patient is still in remission (96+months). This case suggests the feasibility and efficacy of combining surgery, standard and HDCT, and subsequent immunotherapy in metastatic breast cancer. Further investigation of this approach is indicated in a subgroup of patients with oligometastatic breast cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies / therapeutic use
  • Antigens, Neoplasm / immunology
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • CD3 Complex / immunology
  • Cell Adhesion Molecules / immunology
  • Combined Modality Therapy / adverse effects
  • Epirubicin / therapeutic use
  • Epithelial Cell Adhesion Molecule
  • Female
  • Humans
  • Leukapheresis
  • Liver Neoplasms / secondary*
  • Paclitaxel / therapeutic use
  • Remission Induction
  • Thiotepa / therapeutic use
  • Treatment Outcome


  • Antibodies
  • Antigens, Neoplasm
  • CD3 Complex
  • Cell Adhesion Molecules
  • EPCAM protein, human
  • Epithelial Cell Adhesion Molecule
  • Epirubicin
  • Thiotepa
  • Paclitaxel