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Aim: We report a case of a young woman who presented with HER2+ metastatic breast cancer and visceral crisis to asses safety and effectiveness of dual anti-HER2 plus chemotherapy. Patients &amp; methods/materials &amp; methods: At the time of advanced breast cancer diagnosis, the patient presented in scanty clinical condition with severe liver function tests elevation. First-line chemotherapy based on pertuzumab-trastuzumab plus weekly paclitaxel at 50% reduced dose due to liver dysfunction was administered. Results: Improvement and normalization of liver function tests and patient’s clinical condition was recorded in less than 2 months. Computed tomography revealed a partial remission of liver metastasis. Conclusions: Early initiation of standard HER2 target therapies outweigh the risks of toxicities and can be successfully used also in patients with life-threatening liver breast cancer metastasis.

How safe is it to administer dual anti-HER2 block with pertuzumab and trastuzumab on a patient with life-threatening liver breast cancer metastasis?