Efficacy and Safety of Radiotherapy Combined with Pyrotinib in the Treatment of HER2-Positive Breast Cancer with Brain Metastases

Abstract

Purpose

To explore the efficacy and safety of pyrotinib combined with different radiotherapy modes in human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) patients with brain metastasis (BM).

Patients and Methods

This study is a retrospective analysis of patients diagnosed with BM who underwent treatment with pyrotinib between November 2018 and April 2023. A total of 66 patients were administered radiotherapy in conjunction with pyrotinib (Group A), while 26 patients received pyrotinib as a standalone treatment (Group B). Within Group A, 18 patients underwent conventional fractionated radiotherapy (2Gy/F), while 48 patients received hyperfractionated radiotherapy (HFRT) (≥3Gy/F). The primary endpoints were intracranial progression-free survival (IC-PFS) and overall survival (OS). The secondary endpoints were objective response rate (ORR) and clinical benefit rate (CBR).

Results

The ORR of Group A was 54.5% (36/66), while the ORR of Group B was 34.6% (9/26) (P= 0.047). The CBR of Group A was 89.4% (59/66) and that of Group B was 69.2% (18/26) (P= 0.041). The IC-PFS between Group A and Group B were 12 months and 8 months, respectively (P< 0.001), and the OS were 20 months and 16 months, respectively (P= 0.065). In Group A, the IC-PFS and OS between the conventional fractionation radiotherapy group and the HFRT group were 10 months and 12 months, respectively (P= 0.001) and 16 months and 24 months, respectively (P< 0.001). No serious adverse reactions were observed in Group A and Group B.

Conclusion

For HER2-positive BC patients with BM, it is recommended to adopt the treatment mode of HFRT combined with pyrotinib, which can improve the local control and survival of patients.

Keywords:

• breast cancer
• human epidermal growth factor receptor type 2
• brain metastasis
• pyrotinib
• radiation therapy
• hyperfractionated radiotherapy

Data Sharing Statement

The data supporting the results in the manuscript can be obtained from the corresponding author based on reasonable request.

Ethics Approval and Consent to Participate

This retrospective study approved by the Institutional Review Board of The First Affiliated Hospital of Bengbu Medical College (approval number: 2023YJS152). Given that this study was conducted relying on retrospective data collected as part of routine clinical practice, ethical committee waived the consent, and individual informed consent was not obtained. In this retrospective study, no patient identifiers were used and data were anonymized. This study followed the Declaration of Helsinki (2013 revision)

Acknowledgments

The authors wish to thank patients and their kin for supporting our work and thank editors as well as reviewers for reading the manuscript.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was founded by the Natural Science Foundation of Anhui Education Department (No. KJ2021A0699).