Prognostic value of radiotherapy combined with pyrotinib for the treatment of HER2-positive breast cancer with brain metastases
10.3760/cma.j.cn113030-20241103-00422
- VernacularTitle:放疗联合吡咯替尼对HER2阳性乳腺癌脑转移患者的疗效
- Author:
Dongxing SHEN
1
;
Longyu ZHU
1
;
Deyou KONG
1
;
Jun ZHANG
1
;
Zhikun LIU
1
Author Information
1. 河北医科大学第四医院放疗科，石家庄 050035
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Brain metastasis;
Human epidermal growth factor receptor 2;
Pyrotinib;
Radiotherapy
- From:
Chinese Journal of Radiation Oncology
2025;34(11):1117-1123
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of brain radiotherapy combined with pyrotinib and capecitabine in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer with brain metastases.Methods:Clinical data of 30 HER2-positive breast cancer patients with brain metastases treated at the Fourth Hospital of Hebei Medical University between January 2018 and January 2024 were retrospectively analyzed. According to the timing of drug administration, patients were divided into the concurrent radiotherapy and medication group ( n=20) and the sequential group receiving pyrotinib plus capecitabine within 1 month before or after radiotherapy ( n=10). Intracranial progression-free survival (iPFS), intracranial and extracranial objective response rates (ORR), overall survival (OS), and treatment safety were analyzed. Survival curves were plotted using the Kaplan-Meier method, and survival differences were compared by log-rank test. Results:The median follow-up time was 23.5 months (range, 5.2-37.8), with a median iPFS of 13.0 months (range, 1.7-27.3) and a median OS of 28.2 months (range, 7.3-46.2). The 1-year iPFS and OS in the concurrent radiotherapy with pyrotinib and capecitabine group were numerically higher than those in the sequential group treated within 1 month before or after radiotherapy, but the differences were not statistically significant ( P=0.825, 0.724, respectively). The intracranial and extracranial ORRs were 83.3% and 64.3%, respectively. The most common grade ≥3 treatment-related adverse reactions were diarrhea (27%) and neutropenia (23%). Conclusions:Radiotherapy combined with pyrotinib and capecitabine provides prolonged survival benefits with acceptable safety in patients with HER2-positive breast cancer brain metastases. Compared to concurrent administration, pyrotinib plus capecitabine given within 1 month before or after radiotherapy does not appear to affect prognosis.
