PDF(Pubmed)
Abstract：
Breast cancer remains one of the predominant malignancies worldwide. In the context of inoperable advanced or metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer, systemic management primarily relies on HER2-targeting monoclonal antibodies. With the successful development of anti-HER2 antibody-drug conjugates (ADCs), these agents have been increasingly integrated into therapeutic regimens for metastatic breast cancer. Here, we present the case of a 42-year-old female patient with HER2-positive pulmonary metastatic breast cancer who underwent an extensive treatment protocol. This protocol included chemotherapy, radiation therapy, hormonal therapy, surgical intervention on the breast, and anti-HER2 therapies. The anti-HER2 therapies involved both singular and dual targeting strategies using trastuzumab and the ADC disitamab vedotin (RC48) over an 8-year period. After experiencing disease progression following HER2-targeted therapy with RC48, the patient achieved noticeable partial remission through a therapeutic regimen that combined trastuzumab deruxtecan (DS8201) and tislelizumab. The data suggest a promising role for DS8201 in managing advanced stages of HER2-amplified metastatic breast cancer, especially in cases that demonstrate progression after initial HER2-directed therapies using ADCs. Furthermore, its combination with anti-PD-1 agents enhances therapeutic efficacy by augmenting the anti-tumoral immune response.
摘要：
乳腺癌仍然是世界范围内主要的恶性肿瘤之一。在无法手术的晚期或转移性人表皮生长因子受体2（HER2）阳性乳腺癌的情况下，全身管理主要依赖于HER2靶向单克隆抗体.随着抗HER2抗体-药物偶联物（ADC）的成功开发，这些药物已被越来越多地纳入转移性乳腺癌的治疗方案.这里,我们介绍了一例42岁的HER2阳性肺转移性乳腺癌女性患者,该患者接受了广泛的治疗方案.这个方案包括化疗，放射治疗,激素治疗,乳房手术干预，和抗HER2治疗。抗HER2治疗涉及使用曲妥珠单抗和ADCdiitamabvedotin（RC48）的单一和双重靶向策略，为期8年。在使用RC48进行HER2靶向治疗后经历疾病进展后，患者通过联合曲妥珠单抗（DS8201）和tislelizumab的治疗方案实现了明显的部分缓解。数据表明，DS8201在治疗HER2扩增的转移性乳腺癌的晚期中具有有希望的作用。特别是在使用ADC的初始HER2定向治疗后显示进展的病例。此外，其与抗PD-1药物的组合通过增强抗肿瘤免疫应答而增强治疗功效.
