Xiao Xia, Wang Qing-Wen, Zhou Zheng-Yang, Wang Lei-Sheng, Huang Pei
Department of Oncology, Wuxi No. 2 People's Hospital, Jiangnan University Medical Center, Wuxi 214002, Jiangsu Province, China.
Wuxi Medical College, Jiangnan University, Wuxi 214122, Jiangsu Province, China.
World J Gastrointest Oncol. 2025 Apr 15;17(4):102690. doi: 10.4251/wjgo.v17.i4.102690.
Although targeted therapy provides survival benefits for patients with metastatic colorectal cancer, some patients develop resistance to these treatments. Human epidermal growth factor receptor 2 (HER2) is overexpressed in a subset of patients with colorectal cancer and has been established as a therapeutic target.
This case report describes a Chinese patient with HER2-amplified advanced rectal cancer who showed no response to chemotherapy and targeted therapies against epidermal growth factor receptor and vascular endothelial growth factor but achieved a remarkable response following treatment with immune checkpoint inhibitors (ICIs) in combination with pyrotinib. The combination of oxaliplatin and ICIs with pyrotinib demonstrates synergistic effects after late-stage disease progression.
ICIs and pyrotinib may be effective in treating HER2-amplified advanced rectal cancer. Chemotherapy following disease progression could enhance efficacy synergistically.
尽管靶向治疗为转移性结直肠癌患者带来了生存益处，但一些患者会对这些治疗产生耐药性。人表皮生长因子受体2（HER2）在一部分结直肠癌患者中过度表达，并已被确立为治疗靶点。
本病例报告描述了一名HER2扩增的晚期直肠癌中国患者，该患者对化疗以及针对表皮生长因子受体和血管内皮生长因子的靶向治疗均无反应，但在接受免疫检查点抑制剂（ICI）联合吡咯替尼治疗后取得了显著疗效。奥沙利铂与ICI联合吡咯替尼在疾病晚期进展后显示出协同作用。
ICI和吡咯替尼可能对治疗HER2扩增的晚期直肠癌有效。疾病进展后进行化疗可协同增强疗效。
