Pyrotinib as a therapeutic for HER2-positive breast cancer

Kioutchoukova, Ivelina P.; Lucke‐Wold, Brandon

doi:10.21037/tcr-23-333

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…Especially in HER2-positive tumors, there are systemic therapy approaches for the treatment of BMBC: for example, the combination of capecitabine with lapatinib in the LANDSCAPE study showed objective response in BCBM ( 44 ). Furthermore, trastuzumab emtansine or pyrotinib have been shown to have encouraging results in the systemic treatment of BMBC of HER2-positive patients ( 45 , 46 ). In our analysis, we could not detect any statistically significant prognostic factors for median OS.…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological factors and outcome of central nervous system metastasis in breast cancer

Dettwiler,

Chiru,

Daetwyler

et al. 2023

Front. Oncol.

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BackgroundIn Switzerland, approximately 6000 new breast cancer cases and 1300 deaths are reported annually. Brain metastasis from breast cancer (BMBC) has a major effect on prognosis. This study aimed to identify prognostic factors for overall survival (OS) in a cohort of Swiss patients with BMBC. This study evaluated the prognosis on older BMBC, which has not been completely addressed in the literature.MethodsWe performed a retrospective chart review analysis with the primary endpoint of OS after a diagnosis of BMBC. The study population was divided into 2 groups based on an OS cut-off value of 12 months after diagnosis. Univariate and multivariate analyses of several risk factors, including age, were performed. To evaluate differences in OS according to age, we performed a secondary analysis to examine the prognostic value of clinical symptoms, metastatic pattern, and lymph node involvement in an older (≥65 years) vs. younger (<65 years) cohort.ResultsFrom 1989 to 2019, 55 patients were identified as having BMBC, among whom 47 patients were confirmed to be dead. The median patient age was 58 years (range 25–83 years). Comorbidities were present in 45 (81.8%) patients. The median survival in the OS <12 and OS ≥12 months groups was 4.3 and 30.7 months, respectively (p<0.001). Multivariate analysis revealed no significant differences in terms of comorbidities, medication use, M-stage, and symptomatology between the 2 groups. Additionally, there was no significant difference in OS in the 2 subgroups of patients aged <65 and ≥65 years.DiscussionWe concluded that age should not be a decisive factor in therapy planning for advanced breast cancer patients with BMBC.

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Section: Discussionmentioning

confidence: 99%

Clinical and pathological factors and outcome of central nervous system metastasis in breast cancer

Dettwiler,

Chiru,

Daetwyler

et al. 2023

Front. Oncol.

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“…Pyrotinib is a new irreversible inhibitor of epidermal growth factor receptor (EGFR), HER2, and HER4. In the metastatic setting, a recent meta-analysis revealed that pyrotinib-containing regimens demonstrated considerable tumor response, survival outcome and manageable toxicity in any line of treatment for HER2 + metastatic BC ( 10 , 11 ). Recently, the final analysis of the phase II PANDORA trial ( 12 ) suggested that pyrotinib monotherapy plus docetaxel given in the first-line treatment was highly active with an objective response rate (ORR) of 79.7% [95% confidence interval (CI): 70.8–88.6%] among patients with HER2 + advanced BC.…”

Section: Introductionmentioning

confidence: 99%

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

Ye,

Chen,

Liu

et al. 2024

Gland Surg

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Background The effectiveness and safety of pyrotinib have been substantiated in human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer (BC). However, the role of pyrotinib as a single HER2 blockade in neoadjuvant setting among BC patients has not been studied. The objective of this study was to evaluate the efficacy and tolerability of pyrotinib plus taxanes as a novel neoadjuvant regimen in patients with HER2-positive early or locally advanced BC. Methods In this single-arm exploratory phase II trial, patients with treatment-naïve HER2-positive BC (stage IIA–IIIC) received pyrotinib 400 mg once daily and taxanes [docetaxel 75 mg/m 2 or nanoparticle albumin-bound (nab)-paclitaxel 260 mg/m 2 every 3 weeks, or paclitaxel 80 mg/m 2 weekly] for a total of four 21-day cycles before surgery. Efficacy assessment was based on pathological and clinical measurements. The primary endpoint of this study was the total pathological complete response (tpCR) rate. The secondary endpoints included breast pCR (bpCR) rate, investigator-assessed objective response rate (ORR) and adverse events (AEs) profiles. Results From 1 September 2021 to 30 December 2022, a total of 31 patients were enrolled. One patient was withdrawn due to unbearable skin rash after the second cycle of neoadjuvant therapy. The majority of the intention-to-treat (ITT) population was premenopausal (54.8%), had large tumors (90.3%) and metastatic nodes (58.1%) at diagnosis and hormone-receptor positive tumors (64.5%). Most participants used nab-paclitaxel (74.2%) and received mastectomy (67.7%) after neoadjuvant treatment. The tpCR and bpCR rates were 48.4% [95% confidence interval (CI): 30.8–66%] and 51.6% (95% CI: 34–69.2%), respectively. Grade ≥3 treatment-related AEs were observed in 16.1% (5/31) of the ITT population, including diarrhea (n=2, 6.5%), hand and foot numbness (n=1, 3.2%), loss of appetite (n=1, 3.2%), and skin rash (n=1, 3.2%). AE related dose reduction or pyrotinib interruption was not required. Conclusions In female patients with HER2-positive non-metastatic BC, neoadjuvant pyrotinib monotherapy plus taxanes appears to show promising clinical benefit and controllable AEs [Chinese Clinical Trial Registry (ChiCTR2100050870)]. The long-term efficacy and safety of this regime warrant further verification.

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“…27 Pyrotinib has been proven to be an effective and safe drug for tumor treatment, disease control, and controllable adverse reactions. 28 Pyrotinib may offer physicians a new treatment option for patients with HER2-positive advanced BC especially those with BM. With the development of small molecule targeted agents, improvements in intracranial control may outweigh local treatments alone, including WBRT, SRS and surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Radiotherapy Combined with Pyrotinib in the Treatment of HER2-Positive Breast Cancer with Brain Metastases

Huang,

Zhu,

Duan

et al. 2023

BCTT

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To explore the efficacy and safety of pyrotinib combined with different radiotherapy modes in human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) patients with brain metastasis (BM). Patients and Methods:This study is a retrospective analysis of patients diagnosed with BM who underwent treatment with pyrotinib between November 2018 and April 2023. A total of 66 patients were administered radiotherapy in conjunction with pyrotinib (Group A), while 26 patients received pyrotinib as a standalone treatment (Group B). Within Group A, 18 patients underwent conventional fractionated radiotherapy (2Gy/F), while 48 patients received hyperfractionated radiotherapy (HFRT) (≥3Gy/F). The primary endpoints were intracranial progression-free survival (IC-PFS) and overall survival (OS). The secondary endpoints were objective response rate (ORR) and clinical benefit rate (CBR). Results: The ORR of Group A was 54.5% (36/66), while the ORR of Group B was 34.6% (9/26) (P= 0.047). The CBR of Group A was 89.4% (59/66) and that of Group B was 69.2% (18/26) (P= 0.041). The IC-PFS between Group A and Group B were 12 months and 8 months, respectively (P< 0.001), and the OS were 20 months and 16 months, respectively (P= 0.065). In Group A, the IC-PFS and OS between the conventional fractionation radiotherapy group and the HFRT group were 10 months and 12 months, respectively (P= 0.001) and 16 months and 24 months, respectively (P< 0.001). No serious adverse reactions were observed in Group A and Group B. Conclusion: For HER2-positive BC patients with BM, it is recommended to adopt the treatment mode of HFRT combined with pyrotinib, which can improve the local control and survival of patients.

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Pyrotinib as a therapeutic for HER2-positive breast cancer

Cited by 4 publications

References 25 publications

Clinical and pathological factors and outcome of central nervous system metastasis in breast cancer

Clinical and pathological factors and outcome of central nervous system metastasis in breast cancer

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

Efficacy and Safety of Radiotherapy Combined with Pyrotinib in the Treatment of HER2-Positive Breast Cancer with Brain Metastases

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