Efficacy and Safety of Trastuzumab Deruxtecan for HER2-Positive Breast Cancer with Brain Metastases
[Objective]To explore the efficacy and safety of trastuzumab deruxtecan(T-DXd)for human epidermal growth factor receptor 2(HER2)-positive breast cancer with brain metastasis.[Methods]The clinical and pathological data of 15 HER2-positive breast cancer patients with brain metastasis who received T-DXd treatment in Xi'an International Medical Center Hospital from August 2021 to Au-gust 2023 were retrospectively analyzed.The correlation of progress-free survival(PFS)with clinico-pathological characteristics of patients was analyzed with Kaplan-Meier method and Cox regression.[Results]The median treatment line of T-DXd was 5,the median PFS was 6.0 months,and the objective response rate(ORR)of intracranial tumors was 80％.HER2 expression status was signifi-cantly correlated with PFS of patients receiving T-DXd therapy.The median PFS of the HER2 over-expression group was significantly longer than that of the HER2 low expression group(7.0 months vs 3.5 months,P=0.016).Multivariate analysis showed that HER2 overexpression was an independent prognostic factor for PFS(HR=0.215,95％CI:0.054～0.857,P=0.029).Fisher's exact test indicated that none of the studied clinical and pathological factors were significantly associated with ORR of the intracranial tumors.The main adverse reactions of T-DXd in this study were nausea and vomit-ing,leukopenia,neutropenia,thrombocytopenia,anemia,fatigue,etc.,with a low incidence of grade 3 or above adverse reactions.[Conclusion]T-DXd can effectively improve the ORR in HER2-positive breast cancer patients with brain metastasis.HER2 overexpression can be used as a predictive marker of PFS benefits of T-DXd treatment,but it has no significant correlation with the ORR of intracranial tumors.T-DXd therapy has good a tolerance.
breast cancertrastuzumab deruxtecanbrain metastaseshuman epidermal growth factor receptor 2efficacyadverse reaction
NETL
NSTL
万方数据
