<p>Pathological Complete Response from Pyrotinib Combined with Trastuzumab, Paclitaxel and Cisplatin in a Postpartum Woman with HER2-Positive Locally Advanced Breast Cancer: A Case Report</p>

Abstract

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.

Short-term efficacy and safety of neoadjuvant pyrotinib plus taxanes for early HER2-positive breast cancer: a single-arm exploratory phase II trial

“…Recently, various combinations of pyrotinib plus chemotherapy for HER2 + BC in the neoadjuvant setting have been increasingly explored. Several phase II trials showed that dual-target therapy with trastuzumab and pyrotinib plus neoadjuvant chemotherapy (NAC) exhibited pCR rates between 51.6% and 73.7% ( 13 , 15 , 29 , 30 ). A real-world analysis found that the tpCR rate of pyrotinib-containing neoadjuvant therapy was 48.5%, respectively ( 28 ).…”

Tyrosine kinase inhibitors in breast cancer (Review)

“…Pyrotinib combined with trastuzumab, paclitaxel and cisplatin exhibited favorable results (pCR) in HER2-positive locally advanced BC in published case reports (52), while study protocols for randomized trials including pyrotinib are currently under development (53). Clinical trials assessing the effects of TKIs in breast cancer are included in Table I.…”

Case Report: Significant Efficacy of Pyrotinib in the Treatment of Extensive Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Cutaneous Metastases: A Report of Five Cases

“…There is evidence that HER2 targeting TKIs can enhance the ADCC response and thus act in synergy with anti-HER2 mAbs in the treatment of BC (16,17). There have been clinical reports about the therapeutic effect of pyrotinib in patients with metastatic breast cancer (MBC) who have failed trastuzumab and pertuzumab treatment (18)(19)(20)(21)(22)(23), and pyrotinib has also been found to have a good therapeutic effect on other types of HER2-positive advanced malignancies (24)(25)(26)(27)(28)(29)(30).…”