PMID- 36533572 OWN - NLM STAT- MEDLINE DCOM- 20230324 LR - 20230703 IS - 1535-3699 (Electronic) IS - 1535-3702 (Print) IS - 1535-3699 (Linking) VI - 248 IP - 2 DP - 2023 Jan TI - Pyrotinib combining with radiotherapy on breast cancer with brain metastasis. PG - 106-116 LID - 10.1177/15353702221142605 [doi] AB - With the extensive application of anti-human epidermal growth factor receptor-2 (HER2) targeted therapy, the prognosis of HER2-positive breast cancer brain metastasis (BCBM) has been improved greatly. Due to the lack of prospective randomized controlled studies; however, the treatment of active brain metastasis (BM) remains a difficulty in clinic. Based upon the retrospective studies, an effective approach of radiotherapy combined with pyrotinib in HER2-positive BCBM treatment was investigated in present research. In all, 29 patients who had active BM in HER2-positive breast cancer (BC) and underwent whole-brain radiotherapy (WBRT) combined with pyrotinib from January 2019 to May 2021 were enrolled. The progression-free survival (PFS), overall survival (OS), clinical benefit rate (CBR), objective response rate (ORR), and drug-related adverse events (AEs) were analyzed among patients undergoing WBRT combined with concurrent or sequence pyrotinib + capecitabine. After the systematic treatments using WBRT combined with pyrotinib + capecitabine, the mPFS and mOS of BM patients were 6.5 months and 15.5 months, respectively. PFS (7.2 vs 6.2 months, p = 0.038) and OS (19.0 vs 14.0 months, p = 0.014) were longer after sequence treatments than those after concurrent treatment. The central nervous system (CNS) ORR of sequence treatment was superior to that of concurrent treatment (80.4% vs 58.6%, p < 0.05). Vomiting (17.2%) and diarrhea (10.3%) were the most common adverse reactions ⩾ grade 3. WBRT combined with pyrotinib is safe and effective for the treatments of active BM in HER2-positive BC. WBRT combined with sequence pyrotinib + capecitabine is more effective and less toxic than concurrent treatment. Therefore, sequence treatment is potentially a preferred regimen for patients with active BM in HER2-positive BC. The size and number of BM lesions, presence or absence of hepatic metastasis, and combination mode of radiotherapy and targeted therapy are independent risk factors for active BM prognosis. FAU - Ma, Xiaoping AU - Ma X AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Li, Yan AU - Li Y AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Zhao, Zhenhui AU - Zhao Z AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Li, Li AU - Li L AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Gao, Chunyan AU - Gao C AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Liu, Dan AU - Liu D AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Li, Bingyu AU - Li B AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. FAU - Zhao, Bing AU - Zhao B AUID- ORCID: 0000-0002-1594-5504 AD - Department of Breast Cancer, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China. AD - The Clinical Research Center of Breast Tumor and Thyroid Tumor in Xinjiang Uygur Autonomous Region, Urumqi 830011, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221219 PL - Switzerland TA - Exp Biol Med (Maywood) JT - Experimental biology and medicine (Maywood, N.J.) JID - 100973463 RN - 6804DJ8Z9U (Capecitabine) RN - P188ANX8CK (Trastuzumab) RN - 0 (pyrotinib) SB - IM MH - Humans MH - Female MH - *Breast Neoplasms/drug therapy/radiotherapy MH - Capecitabine/therapeutic use/adverse effects MH - Trastuzumab/therapeutic use MH - Retrospective Studies MH - *Brain Neoplasms/drug therapy/radiotherapy PMC - PMC10041048 OTO - NOTNLM OT - Breast cancer OT - brain metastasis OT - human epidermal growth factor receptor-2 (HER2) OT - pyrotinib OT - trastuzumab OT - whole-brain radiotherapy (WBRT) COIS- The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2022/12/20 06:00 MHDA- 2023/03/25 06:00 PMCR- 2023/07/01 CRDT- 2022/12/19 05:52 PHST- 2022/12/20 06:00 [pubmed] PHST- 2023/03/25 06:00 [medline] PHST- 2022/12/19 05:52 [entrez] PHST- 2023/07/01 00:00 [pmc-release] AID - 10.1177_15353702221142605 [pii] AID - 10.1177/15353702221142605 [doi] PST - ppublish SO - Exp Biol Med (Maywood). 2023 Jan;248(2):106-116. doi: 10.1177/15353702221142605. Epub 2022 Dec 19.