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Favorable Response to Bevacizumab Plus Capecitabine in a HER2-negative Breast Cancer Patient with Recurrent Brain
Zihao Zhu1,2,3, Pengfei Zhao1,2,3, Luxuan Wang1,2,4
1Clinical Medicine College, Hebei University, Baoding, Hebei, China.
Background:
Brain metastases represent a major contributor to poor prognosis in cancer patients, with breast cancer-associated brain metastases accounting for a considerable proportion of cases. Owing to the presence of the Blood-Brain Barrier (BBB), most therapeutic agents for breast cancer fail to achieve effective concentrations in brain metastatic lesions. Notably, treatment options are extremely limited for patients with Human Epidermal Growth Factor Receptor 2 (HER2)-negative, Hormone Receptor (HR)-positive breast cancer complicated by brain metastases.
Case Presentation:
In this study, we report the clinical treatment course of a 41-year-old female patient with HER2-negative, HR-positive breast cancer brain metastases. The patient experienced intracranial lesion progression following surgery, radiotherapy, and prior chemotherapy, and was subsequently administered a combination regimen of capecitabine and bevacizumab. Clinical symptoms were relieved after one cycle of treatment, and the therapeutic response was assessed as Partial Remission (PR). Prospective follow-up is ongoing. Following the first cycle of the combination regimen (initiated in February 2025), the patient achieved a partial response. As of the data cutoff date of December 9, 2025, the patient had maintained a Progression-Free Survival (PFS) of 10 months from the start of combination therapy. During the entire treatment course, the patient experienced only one episode of grade 3 myelosuppression (white blood cell count: 1.99 × 109/L; neutrophil count: 1.11 × 109/L), which was well controlled with symptomatic treatment. Capecitabine is characterized by its excellent ability to penetrate the BBB and Blood-Tumor Barrier (BTB), while bevacizumab can potentiate the efficacy of chemotherapeutic drugs via its anti- angiogenic activity.
Conclusion:
The combination of these two agents provided an effective therapeutic option for patients with HER2-negative, HR-positive breast cancer brain metastases, and thus provides a valuable clinical reference for the management of this patient population.
