Apatinib combined with trastuzumab and albumin-bound paclitaxel for treatment of HER2+ breast cancer with brain metastases resistant to anti-HER2 TKIs: A case report

Oncol Lett. 2022 Dec 20;25(2):56. doi: 10.3892/ol.2022.13642. eCollection 2023 Feb.

Abstract

Although human epidermal growth factor receptor 2 (HER2)-targeted therapy significantly improves the prognosis of patients with HER2-positive breast cancer, most patients with advanced breast cancer eventually progress due to drug resistance. At present, there is no standard treatment after patients become resistant to HER2-targeted therapy. Previous studies have indicated that anti-angiogenesis drugs have potential efficacy in the treatment of advanced breast cancer. The present study reported on a case of a pretreated patient with HER2-positive advanced breast cancer with brain metastases who developed resistance to multiple lines of HER2-targeted treatment. The patient was treated with apatinib combined with trastuzumab and albumin-bound paclitaxel. The patient achieved partial response to the third-line treatment with a progression-free survival of 9 months. After combination treatment, the symptoms of headache and vomiting were relieved and all the brain metastases were significantly reduced. The present case indicated that apatinib may have anti-tumor activity in patients with HER2-positive breast cancer with HER2-targeted drug resistance. The present case provides valuable information and may offer a new possibility for the treatment of patients with breast cancer with brain metastases who progressed after clinical treatment with small-molecule anti-HER2 tyrosine kinase inhibitor drugs.

Keywords: HER2 positive breast cancer; angiogenesis; apatinib; brain metastases; case report.

Publication types

  • Case Reports

Grants and funding

This work was supported by funds from Shenzhen Basic Research Program (2018, grant no. JCYJ20180306171227129), the National Natural Science Foundation of China (grant no. 81671750, 2016) and the National Natural Science Foundation of Guangdong Province (grant no. 2016A030312008).