Volume 97, Pages 59-63 (December 2016) Chemosensitization role of fulvestrant in combination with chemotherapy in postmenopausal hormone receptor positive and human epidermal growth factor negative metastatic breast cancer  Qing-qing Luo, Vishnu Prasad Adhikari, Chun-xia Zhao, He Wu, Wei Dai, Xin Li, Yu-tuan Wu, Kai-nan Wu, Ling-quan Kong  Medical Hypotheses  Volume 97, Pages 59-63 (December 2016) DOI: 10.1016/j.mehy.2016.10.017 Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 1 Prevalent mode of treating of HR+ HER2− MBC. CT mainly targets HR+ tumor ingredients while HR− cells keep progressing. For patients react poorly to ET, CT is applied. However, chemotherapy is less effective on HR+ cells. During this process, tumor burden evolves with time and hormone resistance is more likely to occur. Medical Hypotheses 2016 97, 59-63DOI: (10.1016/j.mehy.2016.10.017) Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 2 Chemohormonal therapy with concurrent use of fulvestrant and CT. With this modality, both HR+ and HR− portion of the tumor is covered, realizing double kill. Tumor burden is reduced over a short period of time and hormone resistance is less likely to occur. Medical Hypotheses 2016 97, 59-63DOI: (10.1016/j.mehy.2016.10.017) Copyright © 2016 Elsevier Ltd Terms and Conditions