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Neoadjuvant pyrotinib plus trastuzumab and vinorelbine for HER2-positive locally advanced breast cancer patient who was initially resistant to HP therapy: a case report and literature review
BACKGROUND: Trastuzumab (H) and pertuzumab (P) plus chemotherapy is the standard guideline-recommended neoadjuvant therapy recommended for patients with human epidermal growth factor receptor 2 (HER2)-positive locally advanced breast cancer (BC), which has dramatically improved patient prognosis. Ho...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10005987/ https://www.ncbi.nlm.nih.gov/pubmed/36915810 http://dx.doi.org/10.21037/gs-22-751 |
Sumario: | BACKGROUND: Trastuzumab (H) and pertuzumab (P) plus chemotherapy is the standard guideline-recommended neoadjuvant therapy recommended for patients with human epidermal growth factor receptor 2 (HER2)-positive locally advanced breast cancer (BC), which has dramatically improved patient prognosis. However, over 10% of patients develop primary drug resistance to HP and did not respond to treatment. There is no standard second-line neoadjuvant therapy approach for these individuals at the present. Pyrotinib and vinorelbine have shown promising efficacy in HER2-positive metastatic breast cancer, but their usage in neoadjuvant therapy has not been reported so far. CASE DESCRIPTION: Here, we present a case of a 58-year-old female patient with locally advanced HER2-positive BC who was initially resistant to HP neoadjuvant therapy. Following the failure of the treatment, this patient was given pyrotinib plus trastuzumab and vinorelbine as second-line neoadjuvant therapy. The patient tolerated this treatment well, with mild symptoms of diarrhea. After 6 cycles of neoadjuvant therapy, the efficacy was assessed to be partial remission (PR), and a modified radical mastectomy was finally conducted. This patient remained disease-free for 23 months after surgery. CONCLUSIONS: This is the first report to present a case of neoadjuvant pyrotinib plus trastuzumab and vinorelbine in a patient with HER2-positive locally advanced BC, suggesting that the combination could be a new option for patients who have developed resistance to HP neoadjuvant treatment. |
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