Clinical Progress and Treatment History

• December 2008: Liver biopsy shows ER+ 100%, PR+ 100%, HER-2-Neu 3+ by IHC
• December 2008-May 2009: paclitaxel/bevacizumab
• May 2009-August 2009: capecitabine/bevacizumab
• September 2009-November 2011: letrozole, disease progression
• Biopsy shows ER+ 90%, PR+ 90% and HER-2-Neu 3+ by IHC
• November 2011-April 2013: fulvestrant/trastuzumab; trastuzumab held in January 2013 due to decline in EF, disease progression
• May 2013-October 2013: paclitaxel/lapatinib; paclitaxel stopped due to neuropathy
• October 2013-January 2014: anastrozole/lapatinib
• February 2014-January 2015: trastuzumab emtansine (T-DM1)
• January 2015-March 2015: docetaxel/trastuzumab/pertuzumab (CLEOPATRA)
• March 2015-August 2015: eribulin/trastuzumab/pertuzumab
• August 2015-February 2016: trastuzumab (after optimal response)
• February 2016-October 2016: vinorelbine/trastuzumab/pertuzumab
• October 2016-December 2016: gemcitabine/trastuzumab/pertuzumab
• Liver biopsy shows ER 1+/40%, PR-, HER-2-Neu nonamplified
• Specimen sent for genomic panel testing (December 2016)
• Consideration for clinical trials, including ASCO TAPUR
• January 2017-March 2017: carboplatin
• March 2017-June 2017: doxorubicin liposomal
• August 2017-November 2017: pembrolizumab (received two cycles, but ultimately removed from therapy after persistent abnormal LFTs)

*Therapy change due to disease progression unless otherwise noted.