Lesson from a metastatic male breast cancer case: CDK4/6 plus aromatase inhibitors could not exceed tamoxifen

Abstract Male breast cancer (MaBC) is a rare disease, and treatment approaches are often extrapolated from female breast cancer protocols. We present the case of a 55-year-old male diagnosed with estrogen receptor-positive metastatic breast cancer who exhibited primary resistance to first-line treat...

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Bibliographic Details
Main Authors: Tala Najdi, Samah Seif, Nahed Damaj, Joseph Kattan
Format: Article
Language:English
Published: Springer 2025-05-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02571-7
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Summary:Abstract Male breast cancer (MaBC) is a rare disease, and treatment approaches are often extrapolated from female breast cancer protocols. We present the case of a 55-year-old male diagnosed with estrogen receptor-positive metastatic breast cancer who exhibited primary resistance to first-line treatment with a combination of Palbociclib (CDK4/6 inhibitor) and Letrozole (aromatase inhibitor), despite the proven efficacy of this combination in female breast cancer. Surprisingly, upon switching to Tamoxifen, the patient showed rapid and significant clinical improvement documented as a good partial response on radiologic assessment. This case highlights the potential limitations of CDK4/6 inhibitors plus aromatase inhibitors in MaBC and suggests that Tamoxifen could remain a more reliable first-line endocrine therapy in males. It underscores the need for cautious extrapolation of female breast cancer treatment strategies to MaBC and emphasizes the adherence to classical approaches, such as tamoxifen.
ISSN:2730-6011