Patient selection
pain
DISEASE PROGRESSION, AUTOIMMUNE DISEASES, BRAIN METASTASIS, BREAST CANCER
The following subjects were eligible for this study: diagnosis of metastatic hormone receptor positive (ER and/or PR positive) breast cancer, 18 years of age or greater, disease progression after prior endocrine therapy, and Karnofsky performance status > 70% (ECOG 0–1). All subjects were required to have adequate bone marrow reserve (absolute neutrophil count ≥ 1.5 × 10Patients were excluded from participation in the study if they were pregnant or lactating, had brain metastasis (unless stable for 1 month or more following radiation therapy), were on short-acting or long-acting opioid medication (including morphine, hydromorphone, hydrocodone, fentanyl, tramadol) or had uncontrollable pain with the use of non-narcotic drugs (acetaminophen or non-steroidal medications). Patients on immunosuppressive therapy for autoimmune diseases, organ transplant or indications were also excluded from the study.