Background: Overexpression of human epidermal growth factor receptor 2 (HER2) is associated with aggressive disease and poor prognosis. Traditional HER2-targeted agents can improve clinical outcome and have played an essential role in therapy. Pyrotinib is a newly irreversible tyrosine kinase inhibitor (TKI) that is well developed for the treatment of HER2-positive advanced breast tumors. Case Presentation: A 37-year-old postpartum female was presented at a local hospital and was diagnosed with HER2-positive stage IIIB (cT4N1M0) invasive micropapillary adenocarcinoma in the left breast with left axillary metastatic lymph nodes. The patient failed to respond to two cycles of the doxorubicin plus cyclophosphamide (AC) regimen but achieved clinical partial response (cPR) after 4 cycles of the combination of pyrotinib, trastuzumab, paclitaxel and cisplatin (PTPC) regimen according to radiologic assessments. Then, she underwent left-side modified radical mastectomy (MRM) and achieved pathologic complete response (pCR), as confirmed by postoperative pathology. The patient held on receiving 2 cycles of the targeted therapy plus chemotherapy with trastuzumab, paclitaxel plus cisplatin (TPC) and adjuvant radiation therapy but continued to receive targeted therapy with trastuzumab and pertuzumab during the 1-year follow-up period. There has been no clinical evidence of disease progression so far. Conclusion: Breast cancer overexpressing HER2 is a malignant tumor responsible for many cancer-related deaths. The combination of pyrotinib plus other targeted chemotherapy can dramatically improve the outcome of locally advanced disease.
Breast cancer (BC) with overexpression of human epidermal growth factor receptor 2 (HER2) is closely associated with an elevated risk of multiple distant metastases and unfavorable prognosis. Disitamab Vedotin (RC48) is a newly developed antibody-drug conjugate targeting HER2, which is comprised of hertuzumab coupled to monomethyl auristatin E via a cleavable linker. Pre-clinical studies indicated its strong anti-tumor activity in HER2-positive and low HER2 expression models of BC. The present study reported on the case of a 60-year-old postmenopausal female who suffered from fatigue and was diagnosed with a right-sided BC tumor. The diagnosis was stage IV (cT4N3M1) hormone receptor (HR)-positive and HER2-positive invasive ductal carcinoma with systemic metastases (brain included). The patient initially responded well to 26 cycles of the first-line anti-HER2 targeted therapy plus chemotherapy (trastuzumab+pertuzumab+nab-paclitaxel) combined with whole-brain radiotherapy. However, both extracranial and intracranial lesions achieved progressive disease (PD), which eventually occurred during 5 sequential cycles of maintenance therapy. Subsequently, 4 cycles of second-line treatment (trastuzumab + pyrotinib + capecitabin) were continued until the levels of blood tumor markers CEA, CA15-3 and CA125 were elevated, and systemic PD was able to be attained (the brain metastases were rated as stable disease). Finally, the patient received RC48 as the third-line therapy and achieved a durable and effective clinical response. To date, the patient has benefited from 12 cycles of RC48 without any severe adverse effects. The overall survival was >3 years. The present study showcased that RC48 was effective and tolerable for a patient with HR-and HER2-positive BMBC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.