维迪西妥单抗联合贝伐珠单抗治疗老年人表皮生长因子受体2阳性乳腺癌脑转移难治患者的临床观察

Clinical observation of disitamab vedotin combined with bevacizumab in treatment of elderly patients with refractory HER2-positive breast cancer brain metastases

中文关键词: 老年, 乳腺癌, 人表皮生长因子受体2阳性, 脑转移, 维迪西妥单抗, 贝伐珠单抗

英文关键词: elderly  breast cancer  HER2-positive  brain metastases  disitamab vedotin  bevacizumab

中文摘要:

      目的 观察维迪西妥单抗(DV)联合贝伐珠单抗(BEV)治疗老年人表皮生长因子受体2(HER2)阳性乳腺癌脑转移(BCBM)难治患者的有效性和安全性.方法 选择2022年11月-2023年11月复旦大学附属华山医院肿瘤科收治的老年HER2阳性BCBM患者,选出经曲妥珠单抗、吡咯替尼和放疗均失败的难治患者,接受DV 2 mg/kg+BEV 7.5 mg/kg,每3周1次的联合治疗,分析其疗效和不良反应.结果 3例患者符合标准,分别为脑转移后六线、五线和三线治疗,前二者系DV 1.5 mg/kg每2周1次进展后改为联合治疗,BCBM缩小,无进展生存期(PFS)分别超过22个月和11个月;病例3直接接受联合治疗后BCBM部分缓解,PFS为7.5个月.手足麻木为Ⅰ～Ⅱ级,无其他不良反应.结论 老年HER2阳性BCBM难治患者接受DV联合BEV治疗,初步显示出良好的耐受性和有效性.

英文摘要:

      Objective To observe the efficacy and safety of disitamab vedotin(DV)combined with bevacizumab(BEV)in the treatment of elderly patients with refractory human epidermal growth factor receptor 2(HER2)-positive breast cancer brain metastases(BCBM).Methods The elderly patients with HER2-positive BCBM who were admitted to Depart-ment of Oncology of Huashan Hospital Affiliated to Fudan University from November 2022 to November 2023 and had failed treatment with trastuzumab,pyrotinib,and brain radiotherapy were selected as refractory patients.They received a combined therapy of DV(2 mg/kg)and BEV(7.5 mg/kg),once every 3 weeks.The efficacy and adverse reactions were analyzed.Results Three patients met the recruited criteria.Patient 1,2 and 3 received the combined therapy as their sixth,fifth,and third line of treatment after brain metastasis,respectively.After treatment with DV 1.5 mg/kg,once every 2 weeks in patients 1 and 2,their conditions progressed.After they switched to the combined therapy,their BCBM shrank,and their progression free survival(PFS)exceeded 22 months and 11 months,respectively.In patient 3,the combined therapy was initiated direct-ly.He experienced partial remission of BCBM and his PFS was 7.5 months.All patients experienced hand and foot numbness of graded Ⅰ-Ⅱ without other significant side effects.Conclusion The combined therapy of DV and BEV has shown prelimi-nary good tolerance and response in elderly patients with refractory HER2-positive BCBM.