Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review
We present the first documented oncologic case of a type I Kounis syndrome (KS) following paclitaxel administration, in a very young patient with HER2-positive(+) early-stage breast cancer (BC). KS is a relatively rare acute coronary syndrome triggered by anaphylactic or hypersensitivity reactions,...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | Breast |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977625004825 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850137228306546688 |
|---|---|
| author | Javier Muñoz Sabrina Nucera Nuria Rubira Garcia Isaac Cebrecos Gabriela Oses Sergi Ganau Esther Sanfeliu Pedro Jares Mercedes Marín-Aguilera Patricia Galván Fara Brasó-Maristany Olga Martínez-Sáez Enric Cascos Carme Font Francesco Schettini |
| author_facet | Javier Muñoz Sabrina Nucera Nuria Rubira Garcia Isaac Cebrecos Gabriela Oses Sergi Ganau Esther Sanfeliu Pedro Jares Mercedes Marín-Aguilera Patricia Galván Fara Brasó-Maristany Olga Martínez-Sáez Enric Cascos Carme Font Francesco Schettini |
| author_sort | Javier Muñoz |
| collection | DOAJ |
| description | We present the first documented oncologic case of a type I Kounis syndrome (KS) following paclitaxel administration, in a very young patient with HER2-positive(+) early-stage breast cancer (BC). KS is a relatively rare acute coronary syndrome triggered by anaphylactic or hypersensitivity reactions, of which there is limited awareness among healthcare providers. It is subdivided in four subtypes depending on cardiac artery medical history. While no established management guidelines exist, its treatment requires addressing severe infusion reactions while ensuring proper myocardial perfusion. We hereby illustrate its successful acute management and report on how tumor genomics through the novel HER2DX assay helped re-defining the entire neo/adjuvant oncologic strategy. HER2DX integrates tumor size and nodal involvement with 27 genes’ expression data tracking four biological BC-related and immunologic signatures so to estimate a prognostic and a predictive score. This report demonstrates how clinical and genomic data can be effectively integrated to optimize therapeutic decisions in HER2+ BC, offering a model for personalized care also in atypical and complex cases. |
| format | Article |
| id | doaj-art-62f067031f944c19a9f385cc5b8080d2 |
| institution | OA Journals |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-62f067031f944c19a9f385cc5b8080d22025-08-20T02:30:55ZengElsevierBreast1532-30802025-06-018110446510.1016/j.breast.2025.104465Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative reviewJavier Muñoz0Sabrina Nucera1Nuria Rubira Garcia2Isaac Cebrecos3Gabriela Oses4Sergi Ganau5Esther Sanfeliu6Pedro Jares7Mercedes Marín-Aguilera8Patricia Galván9Fara Brasó-Maristany10Olga Martínez-Sáez11Enric Cascos12Carme Font13Francesco Schettini14Medical Oncology Department, Hospital Clinic of Barcelona, C. Villaroel 170, 08036, Barcelona, SpainTranslational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Department of Human Pathology ''G. Barresi'', University of Messina, 98131, Messina, ItalyAllergy Service, Hospital Clinic of Barcelona, Barcelona, SpainClinic Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, SpainFaculty of Medicine, University of Barcelona, Barcelona, Spain; Radiation Oncology Department, Hospital Clínic de Barcelona, Barcelona, SpainDepartment of Radiology, Diagnosis Imaging Center, Hospital Clinic of Barcelona, Barcelona, SpainTranslational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Department of Pathology, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, Barcelona, SpainDepartment of Pathology, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, Barcelona, SpainReveal Genomic, Barcelona, SpainTranslational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, SpainTranslational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Reveal Genomic, Barcelona, SpainMedical Oncology Department, Hospital Clinic of Barcelona, C. Villaroel 170, 08036, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, SpainDepartment of Cardiology, Hospital Clínic of Barcelona, Barcelona, SpainMedical Oncology Department, Hospital Clinic of Barcelona, C. Villaroel 170, 08036, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, SpainMedical Oncology Department, Hospital Clinic of Barcelona, C. Villaroel 170, 08036, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain; Corresponding author. Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), C. Villaroel 170, 08036, Barcelona, Spain.We present the first documented oncologic case of a type I Kounis syndrome (KS) following paclitaxel administration, in a very young patient with HER2-positive(+) early-stage breast cancer (BC). KS is a relatively rare acute coronary syndrome triggered by anaphylactic or hypersensitivity reactions, of which there is limited awareness among healthcare providers. It is subdivided in four subtypes depending on cardiac artery medical history. While no established management guidelines exist, its treatment requires addressing severe infusion reactions while ensuring proper myocardial perfusion. We hereby illustrate its successful acute management and report on how tumor genomics through the novel HER2DX assay helped re-defining the entire neo/adjuvant oncologic strategy. HER2DX integrates tumor size and nodal involvement with 27 genes’ expression data tracking four biological BC-related and immunologic signatures so to estimate a prognostic and a predictive score. This report demonstrates how clinical and genomic data can be effectively integrated to optimize therapeutic decisions in HER2+ BC, offering a model for personalized care also in atypical and complex cases.http://www.sciencedirect.com/science/article/pii/S0960977625004825Kounis syndromeHER2-PositiveBreast cancerHER2DXGenomics |
| spellingShingle | Javier Muñoz Sabrina Nucera Nuria Rubira Garcia Isaac Cebrecos Gabriela Oses Sergi Ganau Esther Sanfeliu Pedro Jares Mercedes Marín-Aguilera Patricia Galván Fara Brasó-Maristany Olga Martínez-Sáez Enric Cascos Carme Font Francesco Schettini Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review Breast Kounis syndrome HER2-Positive Breast cancer HER2DX Genomics |
| title | Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review |
| title_full | Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review |
| title_fullStr | Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review |
| title_full_unstemmed | Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review |
| title_short | Paclitaxel-related type I Kounis Syndrome in a very young patient with HER2-positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario: a case report and narrative review |
| title_sort | paclitaxel related type i kounis syndrome in a very young patient with her2 positive breast cancer and the role of genomics to disentangle a complex therapeutic scenario a case report and narrative review |
| topic | Kounis syndrome HER2-Positive Breast cancer HER2DX Genomics |
| url | http://www.sciencedirect.com/science/article/pii/S0960977625004825 |
| work_keys_str_mv | AT javiermunoz paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT sabrinanucera paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT nuriarubiragarcia paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT isaaccebrecos paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT gabrielaoses paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT sergiganau paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT esthersanfeliu paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT pedrojares paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT mercedesmarinaguilera paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT patriciagalvan paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT farabrasomaristany paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT olgamartinezsaez paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT enriccascos paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT carmefont paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview AT francescoschettini paclitaxelrelatedtypeikounissyndromeinaveryyoungpatientwithher2positivebreastcancerandtheroleofgenomicstodisentangleacomplextherapeuticscenarioacasereportandnarrativereview |