Key clinical point: Combining radiotherapy with pyrotinib and capecitabine led to improved intracranial survival outcomes and an acceptable radiation necrosis rate in patients with human epidermal growth factor receptor 2-positive ( ERBB2+) breast cancer (BC) with brain metastases.
Major finding: The 1-year central nervous system (CNS) progression-free survival (PFS) rate was 74.9% (95% CI 61.9%-90.7%), and the median CNS PFS was 18.0 months (95% CI 15.5-not reached). Diarrhea (7.5%) was the most common grade ≥ 3 treatment-related adverse event. Asymptomatic radiation necrosis was identified in only 6% of the 67 lesions treated with fractionated stereotactic radiotherapy.
Study details: Findings are from a phase 2 trial that included 40 women with ERBB2+ BC and brain metastases who received fractionated stereotactic or whole-brain radiotherapy and initiated treatment with pyrotinib and capecitabine.
Disclosures: This study was supported by the National Natural Science Foundation of China (NSFC). Three authors declared receiving grants or personal fees from various sources, including the NSFC.
Source: Yang Z et al. Brain radiotherapy with pyrotinib and capecitabine in patients with ERBB2-positive advanced breast cancer and brain metastases: A nonrandomized phase 2 trial. JAMA Oncol. 2024 (Jan 4). doi: 10.1001/jamaoncol.2023.5791