Significant response to apatinib monotherapy in heavily pretreated advanced HER2-positive breast cancer: a case report and literature review

Cancer Biol Ther. 2020 Jul 2;21(7):590-596. doi: 10.1080/15384047.2020.1743159. Epub 2020 Apr 1.

Abstract

Although HER2-targeted therapy has been shown to prolong the survival of patients with HER2-positive breast cancer, most patients eventually progress due to drug resistance. Novel treatment options are urgently needed to overcome resistance to HER2-targeted therapy. The VEGF/VEGFR (Vascular endothelial growth factor and its receptors) pathway is essential in tumor angiogenesis, which may be a promising target in HER2-positive breast cancer providing a rationale for the use of tyrosine kinase inhibitors (TKIs) targeting VEGFR. Here, we present a case of a heavily pretreated advanced breast cancer patient who did not respond to HER2-targeted therapy and developed resistance to multiple lines of HER2-targeted treatment. The patient was treated with apatinib at a dose of 500 mg daily, and obtained partial remission (PR) with a progression-free-stage (PFS) of 6 months. Our case indicates that apatinib might have anti-tumor activity in patients with HER2-positive breast cancer with HER2-targeted resistance. This case is of value which may provide new insights into strategies for HER2-targeted therapy resistance options in the clinic.

Keywords: Apatinib; HER2; VEGFR2; angiogenesis; breast cancer; case report.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Female
  • Humans
  • Pyridines / pharmacology
  • Pyridines / therapeutic use*

Substances

  • Antineoplastic Agents
  • Pyridines
  • apatinib

Grants and funding

This work was supported by the National Natural Science Foundation of China under Grant (NO.81672605); Science and Technology Plan Project of Liaoning Province under Grant (NO.2016007010); Science and Technology Plan Project of Liaoning Province (NO.2013225585) and China Medical University under Grant (QGZ2018004).