Clinical observational studies on different prevention strategies for pyrotinib-related diarrhea

LAI Chunhua; JIA Jing; PAN Lili; WANG Yun; YU Jiangli; YE Yun

Abstract：Objective:To evaluate the incidence and severity of diarrhea in patients with advanced breast cancer re-ceiving pyrotinib as antitumor therapy by adopting different prevention strategies,in order to explore how to improve the tolerability of pyrotinib treatment.Methods:A total of 132 patients with human epithelial growth factor recepetor-2(her-2)positive breast cancer receiving pyrotinib treated from January 2021 to December 2023 were selected and di-vided into control group and observation group using simple randomization.The control group only used antidiarrheal drugs symptomatically after the occurrence of diarrhea,while the observation group adopted a primary prevention proto-col for diarrhea,with different prophylactic drugs administered immediately after the start of treatment.Group A re-ceived loperamide,Group B received montmorillonite,and Group C received probiotics combined with abdominal hot compress.The primary observation indicators included the incidence of all grades of diarrhea,the incidence of grade ≥3 diarrhea,and the incidence of dose reduction.The secondary observation indicators included the time of the first onset of grade ≥3 diarrhea,the frequency and duration of grade ≥3 diarrhea,the cumulative duration of grade ≥3 diarrhea,quality of life scores,and other adverse reactions.Results:Compared with the control group,all three study groups were able to reduce the incidence of diarrhea and the incidence of pyrotinib dose reduction to some extent,delay the first oc-currence of grade ≥3 diarrhea,reduce the number of attacks,and shorten the duration of diarrhea.However,only the loperamide group showed a statistically significant difference in the incidence of grade ≥3 diarrhea compared with the control group.Conclusion:The use of loperamide for primary prevention of diarrhea during pyrotinib treatment can sig-nificantly improve the occurrence of diarrhea-related adverse reactions.Preventive measures such as montmorillonite and probiotics combined with abdominal hot compress can also improve the tolerability of pyrotinib treatment to a cer-tain extent and enhance the compliance of breast cancer patients with antitumor therapy.