Pyrotinib-based treatments in HER2-positive breast cancer patients with brain metastases

作者：Xiaoping Ma, Yan Li, Li Li, Chunyan Gao, Dan Liu, Hongyu Li, Zhenhui Zhao, Bing Zhao · 发表于：Annals of Medicine · 年份：2022 · DOI：10.1080/07853890.2022.2139411 · 被引用次数：14 · 研究领域：Brain Metastases and Treatment、HER2/EGFR in Cancer Research、Lung Cancer Treatments and Mutations

Objectives Extensive application of anti-HER2 targeted therapy improves significantly the HER2-positive advanced breast cancer (BC) prognosis, however, it is still difficult to treat brain metastasis. In current study, we explored effective approaches via combining pyrotinib to treat brain metastasis in patients with HER2-positive advanced BC based upon clinical data.Materials and methods Current study included 61 HER2-positive BC patients with brain metastases (BM) who were treated by pyrotinib-based regimens. The systemic regimens included pyrotinib combined with capecitabine, pyrotinib combined with nab-paclitaxel, and pyrotinib combined with vinorelbine. Patients’ progression-free survival (PFS), overall survival (OS), clinical benefit rate (CBR) and objective response rate (ORR), as well as drug-related adverse events (AEs) in regard of each combination regimen were analyzed.Results Pyrotinib-based systemic therapy resulted in 8.6 months median PFS (mPFS) and 18.0 months median OS (mOS) among the BM patients. Regarding different regimens, the combination of pyrotinib with nab-paclitaxel was superior to the combination with capecitabine and vinorelbine with respect to PFS and OS. The central nervous system (CNS) ORR did not showcase significant difference among 3 regimens, however, nab-paclitaxel combined regimen obtained the best peripheral ORR (84.6%) (p ≤ .05).Conclusions Pyrotinib-based combination therapy is safe for HER2-positive brain metastasis treatment. Compared...