Pyrotinib Treatment in Patients With HER2-positive Metastatic Breast Cancer and Brain Metastasis: Exploratory Final Analysis of Real-World, Multicenter Data

Anwar, Munawar; Chen, Qitong; Ouyang, Dengjie; Wang, Shouman; Xie, Ning; Ouyang, Qi; Fan, Ping; Liu, Qian; Chen, Gannong; Zhou, Enbo; Guo, Lei; Gu, Xiaowen; Ding, Boning; Yang, Xiaohong; Liu, Liping; Deng, Chao; Zhi, Xu; Li, Jing; Wang, Yunqi; Zeng, Shan; Hu, Jinhui; Zhou, Wei; Qiu, Bo; Wang, Zhongming; Weng, Jie; Liu, Mingwen; Li, Yang; Tang, Tiegang; Wang, Jianguo; Zhang, Hui; Dai, Bin; Tang, Wuping; Wu, Tao; Xiao, Man; Li, Xiantao; Liu, Hailong; Li, Lai; Yi, Wei

doi:10.1158/1078-0432.ccr-21-0474

Cited by 41 publications

(36 citation statements)

References 42 publications

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“…Our study is among the few studies to obtain OS data for BM, and the 18.0 months of mOS in our study was also better than the 13.93 months of mOS in another clinical study conducted by Anwar et al. [ 25 ]. The sample size of Anwar, M.’s study was relatively small (39 cases), and only 5 cases (12.8%) were given pyrotinib plus nab-paclitaxel regimen in comparison to 17 cases (27.9%) in our study.…”

Section: Discussionsupporting

confidence: 41%

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

Yan

et al. 2022

Annals of Medicine

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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 with vinorelbine or capecitabine, pyrotinib combined with nab-paclitaxel is more effective with less toxicity, which is the preferable regimen for HER2-positive brain metastasis. KEY MESSAGES Present investigation investigated effective methods through combining pyrotinib to treat brain metastasis with HER2-positive advanced brain cancer. The outcomes verified that pyrotinib-based combination therapy was safe and efficient to treat HER2-positive brain metastasis. Therefore, it is effective to treat brain metastasis applying anti-HER2 targeted therapies although pyrotinib showcases efficiency regarding its treatments for the metastasis.

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Section: Discussionsupporting

confidence: 41%

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

Yan

et al. 2022

Annals of Medicine

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“…The initial benefit of pyrotinib in combination with chemotherapy was not statistically significant compared with pyrotinib alone, probably because our group of patients, with a relatively short follow‐up period, had not all yet reached the end of the event. In another just published study, 25 the median PFS and OS were 8.67 and 13.93 months, respectively in the 39 HER2‐positive breast cancer patients with brain metastases, and they also confirmed the prolonged survival of combined therapy of pyrotinib with surgery or radiation in these patients.…”

Section: Discussionmentioning

confidence: 52%

The efficacy and safety of pyrotinib in treating HER2‐positive breast cancer patients with brain metastasis: A multicenter study

Gao

et al. 2021

Cancer Medicine

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“…It would provide important references for our clinical decision-making. (2) In recent years, relevant studies have reported that small-molecule tyrosine kinase inhibitors could improve the progression and prognosis of BM in HER2-positive BC patients (33)(34)(35). We expect that there could be some clinical trials about pre-emptive medical interventions in the future.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Brain Metastasis and Prognosis in HER2-Positive Breast Cancer: A Single-Institution Retrospective Analysis from China

et al. 2022

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BackgroundBrain metastasis (BM) frequently occurs in HER2-positive breast cancer (BC) patients, but the risk factors of BM in this type of patients are still unknown. Our study aims to assess the risk factors of BM and prognostic analysis in HER2-positive BC patients.MethodsUnivariate analysis used t-test, chi-square test, and Fisher’s exact test to find out the risk factors for BM, and multivariable analysis was done with stepwise logistic regression analysis. Prognostic data analysis was estimated by the Kaplan–Meier method.ResultsA total of 228 HER2-positive BC patients were included, of whom 214 patients were postoperative metastatic patients and 14 patients were de novo stage IV patients. Through comparing the stratified variables between 51 postoperative metastatic patients with BM and 163 postoperative metastatic patients without BM, the multivariate analysis showed that age ≤40 years (OR 2.321, 95% CI: 1.089 to 4.948) and first metastatic site with lung metastasis (OR 2.168, 95% CI: 1.099 to 4.274) were independent risk factors for BM in HER2-positive BC patients. Prognostic data of all 65 HER2-positive BC patients with BM showed that the time from the diagnosis of BC to the development of breast cancer brain metastasis (BCBM) was 36.3 months (95% CI: 30.0 to 42.1 months). The time from the diagnosis of first recurrence and metastasis stage to the diagnosis of BCBM was 11.35 months (95% CI: 7.1 to 18.4 months). The time from the diagnosis of BCBM to the time of follow-up was 24.1 months (95% CI: 13.9 to 37.5 months). Up until the time of follow-up data, a total of 38 patients had died, and the time from the diagnosis of BM of these 38 patients to death was 11.0 months (95% CI: 9.0 to 20.4 months).ConclusionThe prognosis of HER2-positive BC patients with BM was poor due to the lack of effective treatments for BM. Age ≤40 years and first metastatic site with lung metastasis were the independent risk factors for BM in HER2-positive BC patients. Future research about pre-emptive medical interventions may help to improve the prognosis of HER2-positive BC patients with high risk to develop BM.

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Pyrotinib Treatment in Patients With HER2-positive Metastatic Breast Cancer and Brain Metastasis: Exploratory Final Analysis of Real-World, Multicenter Data

Cited by 41 publications

References 42 publications

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

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

The efficacy and safety of pyrotinib in treating HER2‐positive breast cancer patients with brain metastasis: A multicenter study

Risk Factors of Brain Metastasis and Prognosis in HER2-Positive Breast Cancer: A Single-Institution Retrospective Analysis from China

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