Wang Nan, Li Lin, Xiong Youyi, Chi Jiangrui, Liu Xinwei, Zhong Chaochao, Wang Fang, Gu Yuanting
Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2021 Dec 16;11:729212. doi: 10.3389/fonc.2021.729212. eCollection 2021.
Breast cancer (BC) is the most common tumor to develop cutaneous metastases. Most BCs with cutaneous metastasis are human epidermal growth factor receptor 2 (HER2)-positive subtypes. Although the molecular mechanisms of breast cancer metastasis to different sites and the corresponding treatment methods are areas of in-depth research, there are few studies on cutaneous metastasis.
Five HER2-positive BC patients with extensive cutaneous metastases were treated with a regimen containing pyrotinib, a novel small-molecule tyrosine kinase inhibitor that irreversibly blocks epidermal growth factor receptor (EGFR), HER2, and human epidermal growth factor receptor 4 (HER4), then their cutaneous metastases quickly resolved at an astonishing speed and their condition was well controlled during the follow-up period.
This case series reports the significant therapeutic effect of pyrotinib on cutaneous metastases of HER2-positive BC for the first time. Based on this, we recommend that pyrotinib can be used as a supplement to trastuzumab for HER2-positive BC patients with cutaneous metastases. In addition, we should consider that the pan-inhibitory effect of pyrotinib on EGFR, HER2, and HER4 may provide a dual therapeutic effect against HER2 and mucin 1.
乳腺癌(BC)是最常发生皮肤转移的肿瘤。大多数发生皮肤转移的乳腺癌是人类表皮生长因子受体2(HER2)阳性亚型。尽管乳腺癌转移至不同部位的分子机制及相应治疗方法是深入研究的领域,但关于皮肤转移的研究较少。
5例发生广泛皮肤转移的HER2阳性乳腺癌患者接受了包含吡咯替尼的治疗方案,吡咯替尼是一种新型小分子酪氨酸激酶抑制剂,可不可逆地阻断表皮生长因子受体(EGFR)、HER2和人类表皮生长因子受体4(HER4),随后其皮肤转移灶以惊人的速度迅速消退,且在随访期间病情得到良好控制。
本病例系列首次报道了吡咯替尼对HER2阳性乳腺癌皮肤转移具有显著治疗效果。基于此,我们建议吡咯替尼可作为曲妥珠单抗的补充药物,用于治疗发生皮肤转移的HER2阳性乳腺癌患者。此外,我们应考虑到吡咯替尼对EGFR、HER2和HER4的泛抑制作用可能对HER2和黏蛋白1产生双重治疗效果。