Management of advanced HR-positive breast cancer using metabolically supported chemotherapy and repurposed drugs: a case report
Abstract
Introduction: Metastatic hormone receptor-positive (HR+) breast cancer is largely incurable once resistance to conventional treatments occurs. Emerging evidence suggests that progression free and overall survival can improve by targeting the distinct metabolic phenotype of cancer cells (Warburg effect). We report a durable response in a patient with advanced metastatic breast cancer treated with a multimodal "press-pulse" metabolic strategy.
Case presentation: A 49-year-old female from Torino, Italy presented with Stage IV (cT4N1M1) invasive ductal carcinoma (HR+/HER2-, grade 3) with extensive osseous and lymph node metastases, poor performance status (ECOG 3) and severe, debilitating pain. She underwent a combinatorial protocol at ChemoThermia Oncology Center (Istanbul, Turkey) comprising of Metabolically Supported Chemotherapy (MSCT) consisting of docetaxel, doxorubicin, and cyclophosphamide administered following a 14-hour fast and low dose insulin-induced mild hypoglycemia, alongside a strict ketogenic diet (GKI < 2.0). Adjunctive therapies included local and whole-body hyperthermia, hyperbaric oxygen therapy (HBOT), and a combination of repurposed drugs (metformin, aspirin, doxycycline, mebendazole, ivermectin, and famotidine) designed to target metabolic, inflammatory, and survival pathways.
Results: This multimodal treatment protocol was well tolerated, and grade 3/4 adverse events were not observed. The patient noticed symptomatic improvement and functional recovery…
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