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Response to Pyrotinib in a Patient with Metastatic Bladder Urothelial Carcinoma Harboring HER2 V842I Mutation: A Case
Suyao Li1, Qing Liu1,2, Mengling Liu1
1Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Background:
The highest incidence of human epidermal growth factor receptor 2 (HER2) mutations has been observed in bladder cancer (BC). However, the function of HER2 mutation in tumor progression and metastasis remains unclear. Currently, no responses to the pan-HER kinase inhibitor were observed in HER2-mutant BC.
Case Presentation:
We described a patient with metastatic bladder urothelial carcinoma (BUC) carrying a HER2 V842I mutation both in circulating tumor DNA (ctDNA) and biopsy sample. The patient was then treated with a HER2 tyrosine kinase inhibitor, pyrotinib, and responded well. However, the targeting treatment was terminated due to G3 diarrhea. Reduced dose of pyrotinib was later added to late-line treatment, the patient's tumor again responded with a significant decrease in CA199.
Conclusion:
This is the first reported case of HER2 V842I mutation successfully treated with pyrotinib in BUC, suggesting pyrotinib therapy might serve as a therapeutic option for BUC patients harboring HER2 activating mutation.
Insights
This study reports a bladder cancer patient with a HER2 V842I mutation who responded well to pyrotinib treatment. This suggests pyrotinib as a potential therapy for HER2-mutant bladder urothelial carcinoma.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Human epidermal growth factor receptor 2 (HER2) mutations are common in bladder cancer (BC).
- The role of HER2 mutations in BC progression and metastasis is not fully understood.
- Existing pan-HER kinase inhibitors have shown no efficacy in HER2-mutant BC.
Observation:
- A patient with metastatic bladder urothelial carcinoma (BUC) presented with a HER2 V842I mutation in both tumor biopsy and circulating tumor DNA (ctDNA).
- The patient initially responded well to the HER2 tyrosine kinase inhibitor, pyrotinib.
- Treatment was halted due to severe diarrhea, but a reduced dose later led to tumor response and decreased tumor markers.
Findings:
- This is the first documented case of successful pyrotinib treatment for HER2 V842I-mutated BUC.
- Pyrotinib demonstrated efficacy in a patient with advanced, HER2-mutant BUC.
Implications:
- Pyrotinib may represent a viable therapeutic option for BUC patients with activating HER2 mutations.
- Further investigation into pyrotinib's role in HER2-mutant BUC is warranted.
- Targeted therapy for specific HER2 mutations in BUC shows promise.
