BACKGROUND: HER2-positive breast cancer occurs in about 15-20 % of all breast cancers. It is both a prognostic and predictive biomarker and the introduction of anti-HER2 therapy over the last 20 years has significantly improved outcomes in this subset of patients, so that they are now comparable to or better than those of patients with HER2-negative tumors. Approximately 5-10% of patients are diagnosed with metastatic breast cancer. It was good news for these patients when, on April 17, 2020, the FDA approved tucatinib in combination with trastuzumab and capecitabine for adult patients with advanced unresectable or metastatic HER2-positive breast cancer who had received one or more prior anti-HER2-based regimens in the metastatic setting. The efficacy of the regimen was demonstrated in the HER2CLIMB trial, which enrolled 612 patients with HER2-positive metastatic breast cancer who had previously been treated with trastuzumab, pertuzumab, and/or trastuzumab emtansine. Median overall survival for patients in the tucatinib arm was 21.9 months (95% CI 18.3-31.0) compared with 17.4 months (95% CI 13.6-19.9) for patients in the control arm (HR 0.66; 95% CI 0.50-0.87; P = 0.00480). CASE: Our patient is a middle-aged woman without visceral metastatic involvement, but with extensive nodal involvement, skeletal metastatic involvement and left breast almost completely consumed by tumor. This woman had a more or less successful three lines of anti-HER2 therapy and the fourth line of one-year-long systemic treatment with the cytostatic eribulin. The inclusion of tucatinib with trastuzumab and capecitabine in the fifth line of systemic therapy achieved a very nice partial regression of the primary tumor without significant toxicity. CONCLUSION: In this case report, we describe the case of a highly pretreated patient with HER-2 positive metastatic breast cancer.

• Klíčová slova
• HER2 positivity, breast cancer, highly pretreated patient, palliative biotherapy,
• MeSH
• chinazoliny terapeutické užití   MeSH
• furany terapeutické užití   MeSH
• ketony terapeutické užití   MeSH
• lidé MeSH
• nádory prsu * farmakoterapie   patologie   MeSH
• oxazoly MeSH
• paliativní péče * MeSH
• polyetherové polyketidy MeSH
• protokoly protinádorové kombinované chemoterapie terapeutické užití   MeSH
• pyridiny terapeutické užití   MeSH
• receptor erbB-2 * metabolismus   MeSH
• trastuzumab terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• chinazoliny MeSH
• ERBB2 protein, human MeSH Prohlížeč
• eribulin MeSH Prohlížeč
• furany MeSH
• ketony MeSH
• oxazoly MeSH
• polyetherové polyketidy MeSH
• pyridiny MeSH
• receptor erbB-2 * MeSH
• trastuzumab MeSH
• tucatinib MeSH Prohlížeč

Oceans cover a large part of our planet and they are a home for an enormous amount of species. A lot of them are still waiting to be discovered by man, much like the chemicals they synthesize. Marine pharmacology concerns itself with the study of these chemicals and their potential use in medicine. Origin in marine species is for the most part the only thing this large and diverse group of substances have in common, so the spectrum of possible applications is quite wide. Many of these substances have a unique mechanism of action, offering new therapeutic possibilities. Although just a few of them are used in a clinical practice today (e.g. eribulin, cytarabine), the future looks quite promising. Current clinical trials focus mostly on the therapy of cancer, but trials for therapy of pain or Alzheimers disease and many others are also underway.Key words: marine pharmacology.

• MeSH
• Alzheimerova nemoc terapie   MeSH
• biologické přípravky farmakologie   MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• management bolesti MeSH
• nádory terapie   MeSH
• oceány a moře MeSH
• vodní organismy chemie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• oceány a moře MeSH
• Názvy látek
• biologické přípravky MeSH