Long‑term remission under Disitamab Vedotin (RC48) in HR‑positive/HER2‑positive metastatic breast cancer with brain meningeal, and bone marrow involvement: A case report

Wu,Qifeng; He,Lina; Luo,Jing; Jin,Wen; Xu,Yingchun; Wang,Chen

doi:10.3892/ol.2022.13459

Long‑term remission under Disitamab Vedotin (RC48) in HR‑positive/HER2‑positive metastatic breast cancer with brain meningeal, and bone marrow involvement: A case report

Authors:
- Qifeng Wu
- Lina He
- Jing Luo
- Wen Jin
- Yingchun Xu
- Chen Wang
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Affiliations: School of Medicine, Shanghai Jiaotong University, Shanghai 200127, P.R. China, Department of Oncology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200127, P.R. China, Department of Oncology, Minhang Branch, Zhongshan Hospital, Fudan University, Shanghai 201100, P.R. China
Published online on: August 12, 2022 https://doi.org/10.3892/ol.2022.13459
Article Number: 339
Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Breast cancer (BC) with overexpression of human epidermal growth factor receptor 2 (HER2) is closely associated with an elevated risk of multiple distant metastases and unfavorable prognosis. Disitamab Vedotin (RC48) is a newly developed antibody‑drug conjugate targeting HER2, which is comprised of hertuzumab coupled to monomethyl auristatin E via a cleavable linker. Pre‑clinical studies indicated its strong anti‑tumor activity in HER2‑positive and low HER2 expression models of BC. The present study reported on the case of a 60‑year‑old postmenopausal female who suffered from fatigue and was diagnosed with a right‑sided BC tumor. The diagnosis was stage IV (cT4N3M1) hormone receptor (HR)‑positive and HER2‑positive invasive ductal carcinoma with systemic metastases (brain included). The patient initially responded well to 26 cycles of the first‑line anti‑HER2 targeted therapy plus chemotherapy (trastuzumab+pertuzumab+nab‑paclitaxel) combined with whole‑brain radiotherapy. However, both extracranial and intracranial lesions achieved progressive disease (PD), which eventually occurred during 5 sequential cycles of maintenance therapy. Subsequently, 4 cycles of second‑line treatment (trastuzumab + pyrotinib + capecitabin) were continued until the levels of blood tumor markers CEA, CA15‑3 and CA125 were elevated, and systemic PD was able to be attained (the brain metastases were rated as stable disease). Finally, the patient received RC48 as the third‑line therapy and achieved a durable and effective clinical response. To date, the patient has benefited from 12 cycles of RC48 without any severe adverse effects. The overall survival was >3 years. The present study showcased that RC48 was effective and tolerable for a patient with HR‑ and HER2‑positive BMBC.

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