Dose-reduced trastuzumab deruxtecan can be safely used in liver failure and active leptomeningeal metastases

Abstract

Trastuzumab deruxtecan has been shown to have responses in heavily pretreated patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. However, the safety of this medication in patients with severe liver dysfunction and untreated or symptomatic central nervous system metastases is unknown. We describe a patient with metastatic HER2-positive breast cancer with liver failure and leptomeningeal metastases who was treated with dose-reduced trastuzumab deruxtecan. With treatment, the patient’s hyperbilirubinemia resolved and she demonstrated a response on imaging. She was dose-escalated to full dose with minimal adverse events.

Long-term response to sequential anti-HER2 therapies including trastuzumab-deruxtecan in a patient with HER2-positive metastatic breast cancer with leptomeningeal metastases: a case report and review of the literature

“…In 2020, Higashiyamaa et al. published the case of a patient with heavily pretreated HER2+ BC with metastases to the CNS and liver ( 59 ). The diagnostic of LM was suspected based on clinical and MRI features, CSF cytology was not documented.…”