Objective To explore the efficacy and safety of the second line and above of trastuzumab deruxte-can in the treatment of advanced breast cancer.Methods The study retrospectively analyzed the clinical data of 34 pa-tients of metastatic breast cancer with HER-2-positive or HER-2-low who were treated with trastuzumab deruxtecan at the Department of Oncology,the First Affiliated Hospital of University of Science and Technology of China from March 2023 to March 2024.The analysis encompassed an evaluation of clinicopathological characteristics,objective response rate,disease control rate and incidence of adverse reactions of the patients.Statistical analysis was performed utilizing Fisher's exact test.Results A total of 34 women were enrolled,with a median age of 55.5 years.Of these participants,25 pa-tients were identified as HER-2-positive,while 9 patients exhibited low expression of HER-2.The number of treatment lines ranged from 2 to 8,with a median of 4 lines.The objective response rate was 35.29％(12/34),and the disease control rate was 58.82％(20/34).Notably,the disease control rate of patients with more than three lines and visceral crisis was significantly lower than that of patients with early line and no visceral crisis,and there was statistically signifi-cant(P＜0.05).The most common adverse reactions included nausea,fatigue,increased aspartate aminotransferase and myelosuppression.Grade 3 or higher adverse reactions were primarily hematological toxicities such as leukopenia,agranu-locytosis,thrombocytopenia,lymphocytopenia and diarrhea,while the remaining reactions were of grade 1-2 severity.Conclusions Trastuzumab deruxtecan has shown both efficacy and safety in the treatment of metastatic breast cancer with HER-2 positive or low expression.Early initiation of trastuzumab deruxtecan is advised.
Breast neoplasmsTrastuzumab deruxtecanHER-2Program evaluationDrug-related side effects and adverse reactions
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