Comparative Efficacy of Tyrosine Kinase Inhibitors and Antibody–Drug Conjugates in HER2-Positive Metastatic Breast Cancer Patients with Brain Metastases: A Systematic Review and Network Meta-Analysis

Wang, Yan; Xu, Honghao; Wu, Yungang; Wang, Jiayu

doi:10.3390/cancers14143372

Cited by 6 publications

(5 citation statements)

References 59 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, traditional anti-HER2 agents such as trastuzumab and pertuzumab, are considered ineffective against BCBM because they are unable to cross the BBB. 10 …”

Section: Discussionmentioning

confidence: 99%

Treatment of HER2-Positive Breast Cancer with Brain Metastases Using Anlotinib and Trastuzumab Deruxtecan: A Case Report

Chen,

Liu,

Wen

et al. 2024

IJWH

View full text Add to dashboard Cite

Breast cancer with brain metastasis accounts for the second largest number of brain metastases among solid malignancies. Despite advances in HER2-targeted therapy, 50% of patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer develop brain metastases and are associated with poor outcomes. In this article, we report the case of a patient with HER2+ metastatic breast cancer who developed brain metastases, despite experiencing a durable effect on extracranial metastases after treatment with trastuzumab and pertuzumab. The patient exhibited intracranial progression while receiving treatment with trastuzumab deruxtecan monotherapy after secondary brain radiotherapy and multiple lines of therapy with anti-HER2 agents, such as pyrotinib, lapatinib, tucatinib, and ado-trastuzumab emtansine. However, the administration of anlotinib (an antiangiogenesis medication) and trastuzumab deruxtecan resulted in intracranial and extracranial partial response and was linked to manageable side effects. The present case indicates that the combination of anlotinib and trastuzumab deruxtecan may be a promising treatment option for patients with HER2+ breast cancer with brain metastasis. Nevertheless, further studies are warranted to verify the present findings.

show abstract

“…However, traditional anti-HER2 agents such as trastuzumab and pertuzumab, are considered ineffective against BCBM because they are unable to cross the BBB. 10 …”

Section: Discussionmentioning

confidence: 99%

Treatment of HER2-Positive Breast Cancer with Brain Metastases Using Anlotinib and Trastuzumab Deruxtecan: A Case Report

Chen,

Liu,

Wen

et al. 2024

IJWH

View full text Add to dashboard Cite

show abstract

“…Our patient developed rapid, symptomatic, and diffuse BMs after only 3 months from starting chemotherapy. It is well known that one-third of patients with metastatic TNBC will eventually develop BMs ( 8 ): As opposed to the HER2-positive breast cancer counterpart, for which several target therapies exist ( 29 ), drugs with potential intracranial efficacy are not available for TNBC and are under investigation ( 9 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

Sacituzumab govitecan and radiotherapy in metastatic, triple-negative, and BRCA-mutant breast cancer patient with active brain metastases: A case report

et al. 2023

View full text Add to dashboard Cite

BackgroundTriple-negative breast cancer (TNBC) is an aggressive cancer subtype, owing to its high metastatic potential: Patients who develop brain metastases (BMs) have a poor prognosis due to the lack of effective systemic treatments. Surgery and radiation therapy are valid options, while pharmacotherapy still relies on systemic chemotherapy, which has limited efficacy. Among the new treatment strategies available, the antibody-drug conjugate (ADC) sacituzumab govitecan has shown an encouraging activity in metastatic TNBC, even in the presence of BMs.Case presentationA 59-year-old woman was diagnosed with early TNBC and underwent surgery and subsequent adjuvant chemotherapy. A germline pathogenic variant in BReast CAncer gene 2 (BRCA2) was revealed after genetic testing. After 11 months from the completion of adjuvant treatment, she had pulmonary and hilar nodal relapse and began first-line chemotherapy with carboplatin and paclitaxel. However, after only 3 months from starting the treatment, she experienced relevant disease progression, due to the appearance of numerous and symptomatic BMs. Sacituzumab govitecan (10 mg/kg) was started as second-line treatment as part of the Expanded Access Program (EAP). She reported symptomatic relief after the first cycle and received whole-brain radiotherapy (WBRT) concomitantly to sacituzumab govitecan treatment. The subsequent CT scan showed an extracranial partial response and a near-to-complete intracranial response; no grade 3 adverse events were reported, even if sacituzumab govitecan was reduced to 7.5 mg/kg due to persistent G2 asthenia. After 10 months from starting sacituzumab govitecan, a systemic disease progression was documented, while intracranial response was maintained.ConclusionsThis case report supports the potential efficacy and safety of sacituzumab govitecan in the treatment of early recurrent and BRCA-mutant TNBC. Despite the presence of active BMs, our patient had a progression-free survival (PFS) of 10 months in the second-line setting and sacituzumab govitecan was safe when administered together with radiation therapy. Further real-world data are warranted to confirm sacituzumab govitecan efficacy in this patient population.

show abstract

“…In HER2+ breast cancer, T-DM1 made its debut to revolutionize the field [ 78 ], and ADCs are being developed in hopes of better treatment options. In this sense, ADCs have shown promising results against brain metastases [ 79 ] and in HER2-low breast cancer [ 80 ]. There are currently 14 FDA-approved ADCs for various cancers, with the target molecule, conjugated drugs, and/or the linkers varying.…”

Section: Her2-targeted Therapiesmentioning

confidence: 99%

Emerging Targeted Therapies for HER2-Positive Breast Cancer

Mercogliano

Bruni

Mauro

et al. 2023

Cancers

View full text Add to dashboard Cite

Breast cancer is the most common cancer in women and the leading cause of death. HER2 overexpression is found in approximately 20% of breast cancers and is associated with a poor prognosis and a shorter overall survival. Tratuzumab, a monoclonal antibody directed against the HER2 receptor, is the standard of care treatment. However, a third of the patients do not respond to therapy. Given the high rate of resistance, other HER2-targeted strategies have been developed, including monoclonal antibodies such as pertuzumab and margetuximab, trastuzumab-based antibody drug conjugates such as trastuzumab-emtansine (T-DM1) and trastuzumab-deruxtecan (T-DXd), and tyrosine kinase inhibitors like lapatinib and tucatinib, among others. Moreover, T-DXd has proven to be of use in the HER2-low subtype, which suggests that other HER2-targeted therapies could be successful in this recently defined new breast cancer subclassification. When patients progress to multiple strategies, there are several HER2-targeted therapies available; however, treatment options are limited, and the potential combination with other drugs, immune checkpoint inhibitors, CAR-T cells, CAR-NK, CAR-M, and vaccines is an interesting and appealing field that is still in development. In this review, we will discuss the highlights and pitfalls of the different HER2-targeted therapies and potential combinations to overcome metastatic disease and resistance to therapy.

show abstract

Comparative Efficacy of Tyrosine Kinase Inhibitors and Antibody–Drug Conjugates in HER2-Positive Metastatic Breast Cancer Patients with Brain Metastases: A Systematic Review and Network Meta-Analysis

Cited by 6 publications

References 59 publications

Treatment of HER2-Positive Breast Cancer with Brain Metastases Using Anlotinib and Trastuzumab Deruxtecan: A Case Report

Treatment of HER2-Positive Breast Cancer with Brain Metastases Using Anlotinib and Trastuzumab Deruxtecan: A Case Report

Sacituzumab govitecan and radiotherapy in metastatic, triple-negative, and BRCA-mutant breast cancer patient with active brain metastases: A case report

Emerging Targeted Therapies for HER2-Positive Breast Cancer

Contact Info

Product

Resources

About