Atezolizumab-induced hemolytic anemia – A case report

Introduction Atezolizumab is currently the only immunotherapy used in conjunction with nab-paclitaxel for locally advanced or triple negative breast cancer. Limited data is available regarding hemolytic anemia as a side effect of atezolizumab. Case report We describe a 59-year-old female with a history of triple negative breast cancer with bone metastases presenting for follow up on Cycle 1, Day 15 of atezolizumab and nab-paclitaxel (100 mg/m2). Patient’s complete blood count (CBC) showed macrocytic anemia, with further workup significant for autoimmune hemolytic anemia (AIHA) attributed to atezolizumab. Management and outcome: Patient was started on a high dose prednisone taper starting at 80 mg daily for 16 days, folic acid 1 mg three times daily, iron sucrose, and darbepoetin alfa. Patient’s counts recovered, and she was able to start Cycle 2 and continued through Cycle 10 without any additional pre-medications. Discussion Hemolytic anemia induced by atezolizumab is a rare side effect that was successfully treated in this patient with a prednisone taper.

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A case report of locally advanced triple negative breast cancer showing pathological complete response to weekly paclitaxel with bevacizumab treatment following disease progression during anthracycline-based neoadjuvant chemotherapy

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2017.08.055 ◽

2017 ◽

Vol 39 ◽

pp. 293-296

Author(s):

Hideo Shigematsu ◽

Shinji Ozaki ◽

Daisuke Yasui ◽

Taizo Hirata

Keyword(s):

Breast Cancer ◽

Case Report ◽

Neoadjuvant Chemotherapy ◽

Disease Progression ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Pathological Complete Response ◽

Locally Advanced ◽

Complete Response ◽

Bevacizumab Treatment

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Locally advanced triple negative breast cancer arising from fibroadenoma with complete response to neoadjuvant chemotherapy: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.02.059 ◽

2020 ◽

Vol 68 ◽

pp. 234-238

Author(s):

Sho Shiino ◽

Masayuki Yoshida ◽

Momoko Tokura ◽

Chikashi Watase ◽

Takeshi Murata ◽

...

Keyword(s):

Breast Cancer ◽

Case Report ◽

Neoadjuvant Chemotherapy ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Locally Advanced ◽

Complete Response ◽

Response To Neoadjuvant Chemotherapy

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Autoimmune hemolytic anemia, rare immune-related adverse event after combination atezolizumab and paclitaxel treatment in recurrent triple-negative breast cancer: A case-report

Journal of Medical Case Reports and Case Series ◽

10.38207/jmcrcs20210042 ◽

2021 ◽

pp. 1-5

Keyword(s):

Breast Cancer ◽

Adverse Event ◽

Case Report ◽

Hemolytic Anemia ◽

Triple Negative Breast Cancer ◽

Autoimmune Hemolytic Anemia ◽

Triple Negative ◽

Related Adverse Event ◽

Paclitaxel Treatment

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A phase II randomized trial of cobimetinib plus chemotherapy, with or without atezolizumab, as first-line treatment for patients with locally advanced or metastatic triple-negative breast cancer (COLET): primary analysis

Annals of Oncology ◽

10.1016/j.annonc.2021.01.065 ◽

2021 ◽

Author(s):

A. Brufsky ◽

S.B. Kim ◽

Ž. Zvirbule ◽

A. Eniu ◽

J. Mebis ◽

...

Keyword(s):

Breast Cancer ◽

Randomized Trial ◽

Phase Ii ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Locally Advanced ◽

Line Treatment ◽

First Line ◽

Primary Analysis ◽

First Line Treatment

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CD44 Targeted Nanomaterials for Treatment of Triple-Negative Breast Cancer

Cancers ◽

10.3390/cancers13040898 ◽

2021 ◽

Vol 13 (4) ◽

pp. 898

Author(s):

Ghazal Nabil ◽

Rami Alzhrani ◽

Hashem Alsaab ◽

Mohammed Atef ◽

Samaresh Sau ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

In Vivo Studies ◽

High Dose ◽

Luminal A ◽

Combination Strategy ◽

Ongoing Research

Identified as the second leading cause of cancer-related deaths among American women after lung cancer, breast cancer of all types has been the focus of numerous research studies. Even though triple-negative breast cancer (TNBC) represents 15–20% of the number of breast cancer cases worldwide, its existing therapeutic options are fairly limited. Due to the pivotal role of the presence/absence of specific receptors to luminal A, luminal B, HER-2+, and TNBC in the molecular classification of breast cancer, the lack of these receptors has accounted for the aforementioned limitation. Thereupon, in an attempt to participate in the ongoing research endeavors to overcome such a limitation, the conducted study adopts a combination strategy as a therapeutic paradigm for TNBC, which has proven notable results with respect to both: improving patient outcomes and survivability rates. The study hinges upon an investigation of a promising NPs platform for CD44 mediated theranostic that can be combined with JAK/STAT inhibitors for the treatment of TNBC. The ability of momelotinib (MMB), which is a JAK/STAT inhibitor, to sensitize the TNBC to apoptosis inducer (CFM-4.16) has been evaluated in MDA-MB-231 and MDA-MB-468. MMB + CFM-4.16 combination with a combination index (CI) ≤0.5, has been selected for in vitro and in vivo studies. MMB has been combined with CD44 directed polymeric nanoparticles (PNPs) loaded with CFM-4.16, namely CD44-T-PNPs, which selectively delivered the payload to CD44 overexpressing TNBC with a significant decrease in cell viability associated with a high dose reduction index (DRI). The mechanism underlying their synergism is based on the simultaneous downregulation of P-STAT3 and the up-regulation of CARP-1, which has induced ROS-dependent apoptosis leading to caspase 3/7 elevation, cell shrinkage, DNA damage, and suppressed migration. CD44-T-PNPs showed a remarkable cellular internalization, demonstrated by uptake of a Rhodamine B dye in vitro and S0456 (NIR dye) in vivo. S0456 was conjugated to PNPs to form CD44-T-PNPs/S0456 that simultaneously delivered CFM-4.16 and S0456 parenterally with selective tumor targeting, prolonged circulation, minimized off-target distribution.

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