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Case Reports
. 2025 Apr 25:16:1574286.
doi: 10.3389/fphar.2025.1574286. eCollection 2025.

Excellent efficacy of trastuzumab deruxtecan in a patient with HER2-positive advanced breast cancer complicated by pulmonary lymphangitic carcinomatosis: a case report and literature review

Simin Luo #  1 , Jie Chai #  1 , Linxiaoxiao Ding  1 , Song Tang  2
Affiliations
Case Reports

Excellent efficacy of trastuzumab deruxtecan in a patient with HER2-positive advanced breast cancer complicated by pulmonary lymphangitic carcinomatosis: a case report and literature review

Simin Luo et al. Front Pharmacol. .

Abstract

Trastuzumab deruxtecan (T-DXd or DS-8201), as a novel antibody-drug conjugate, has demonstrated good efficacy in HER2-positive advanced breast cancer. However, its effectiveness in treating pulmonary lymphangitic carcinomatosis (PLC) has not been previously reported. This paper presents a case of a HER2-positive advanced breast cancer patient who experienced disease progression after treatment with trastuzumab and pertuzumab. The patient developed multiple metastases along with PLC and subsequently received T-DXd treatment, achieving 14.2 months of progression-free survival (PFS). This case is the first to reveal the therapeutic potential of T-DXd in breast cancer patients with PLC.

Keywords: DS-8201; advanced breast cancer; case report; pulmonary lymphangitic carcinomatosis; trastuzumab deruxtecan.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Chest CT showed gradual improvement of PLC following T-DXd treatment. (A–C) Cross-sectional images taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively. (D–F) Coronal images taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively.
FIGURE 2
FIGURE 2
Chest and abdominal CT scans revealed a gradual reduction in the size of the hepatic metastases and mediastinal lymph nodes. (A–C) Liver cross-sectional images taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively. (D–F) Mediastinal cross-sectional images taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively.
FIGURE 3
FIGURE 3
Cranial MRI showed gradual shrinkage of the brain metastases in various regions. (A–C) Coronal images of the left parietal lobe taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively. (D–F) Coronal images of the right temporal lobe taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively. (G–I) Coronal images of the right occipital lobe taken on 20 March 2023, 10 July 2023, and 14 November 2023, respectively.
See this image and copyright information in PMC

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