Pyrotinib-based therapy for patients with HER2-positive advanced breast cancer

This study aimed to investigate pyrotinib (Irene)-based therapy as a treatment for patients with HER2-positive advanced breast cancer. 

This study concluded that pyrotinib-based therapy was safe and effective in these patients, particularly in those that received 2 or fewer therapies and received capecitabine (Xeloda).  

HER2-positive breast cancer (BC) is an aggressive form of BC. It has the protein HER2 on cancer cells which stimulates the growth and spread of BC cells. It also results in a poorer prognosis. Pyrotinib is a type of targeted therapy, called a tyrosine kinase inhibitor (TKI) developed for treatment for HER2-positive advanced solid tumors. It blocks HER2 and stops cancer cells from spreading and growing.

Previous studies have shown that pyrotinib combined with capecitabine improves the survival without cancer worsening of patients with HER2-positive BC. However, clinical trials often include young and fit patients. Therefore it is important to evaluate the safety and effectiveness of pyrotinib in patients with HER2-positive BC in a real-world setting. 

This study involved 141 patients with HER2-positive advanced BC. All patients were treated with pyrotinib-based therapy in 21-day cycles. The average follow-up period was 11.3 months. 

Overall, the average survival without cancer worsening was 12 months. In patients with cancer spread to the liver (liver metastases), the average survival without cancer worsening was lower compared to those without liver metastases (8.7 months vs 12.3 months).  

Patients who received pyrotinib-based therapy as their first or second line of treatment had a better survival without cancer worsening (15.1 months) compared to 8.4 months in those who received pyrotinib-based therapy as their third or greater treatment. 

There was no significant difference in survival without cancer worsening in patients that previously received trastuzumab (Herceptin) and those who did not. However, patients who also received capecitabine had a higher survival without cancer worsening compared to those that did not receive capecitabine (15.1 months vs 8.4 months). 

In patients with brain metastases, it was estimated that 70% of patients were alive without cancer worsening at 6 months. At 12 months, this rate was 60%. The most common side effect was diarrhea in 85% of patients. 

This study concluded that pyrotinib-based therapy was safe and effective in patients with HER2-positive breast cancer, especially in patients treated with pyrotinib as first or second line of treatment and receiving regimens with capecitabine.  

This study had a small number of participants and a short follow-up period. Larger studies are needed.