Combination of vinorelbine capsules and the small molecule anti-angiogenic drug apatinib for first-line treatment of advanced triple-negative breast cancer with schizophrenia after failure of anthracycline and taxane therapy: A case report.

Patients with metastatic triple-negative breast cancer (mTNBC) face a poor prognosis, with limited treatment options and short progression-free survival. Chemotherapy remains a cornerstone in the treatment of mTNBC, but median overall survival is limited to 2-3 years. Oral vinorelbine, whether used alone or in combination with other agents, has demonstrated efficacy in treating metastatic breast cancer. Anti-angiogenic drugs also hold promise for managing advanced breast cancer. The present study reports a case of a patient with advanced TNBC and schizophrenia who progressed following adjuvant chemotherapy with anthracyclines and taxanes. Following recurrence and metastasis, the patient was treated with first-line vinorelbine capsules combined with the small molecule anti-angiogenic drug apatinib, and achieved partial remission. The initial time to first progression (due to patient-led treatment discontinuation) was 14 months; however, despite multiple interruptions and rechallenges, the combination provided long-term disease control spanning over 6 years from the start of first-line therapy. Due to the high cost of apatinib, the patient discontinued it and switched to a regimen of vinorelbine capsules combined with capecitabine. The present case demonstrated that while the combination showed efficacy, treatment adherence and cost were major limitations. These findings indicated that vinorelbine capsules combined with apatinib offered notable efficacy and acceptable safety in this patient with schizophrenia, thus representing a potential therapeutic option for advanced TNBC, but further study is warranted. Notably, the combined treatment did not induce or worsen the patient's schizophrenia. Overall, the present case provided valuable insights in treating patients with breast cancer with schizophrenia.