Analysis of the efficacy and prognosis of paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of human epidermal growth factor receptor 2 positive breast cancer with lung metastasis

Zhang Shengyao; Ye Jiangtao; Liu Hui; Jiang Lina; Zhang Wei

doi:10.3760/j.issn.1673-4777.2025.12.012

Abstract：Objective To investigate the efficacy and prognosis of paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of human epidermal growth factor receptor 2(HER-2)positive breast cancer with lung metastasis.Methods A total of 80 patients with HER-2 positive breast cancer and lung metastasis admitted to the Department of Oncology,Cangzhou Central Hospital,Hebei Medical University from January 2023 to January 2024 were selected.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.The control group was treated with paclitaxel for injection(albumin-bound)intravenous injection,and the observation group was treated with pyrotinib on the basis of the control group,with 21 d as a treatment cycle,a total of 4 cycles of treatment.The therapeutic effects of the two groups were evaluated.The levels of T lymphocyte subsets and serum tumor markers carcinoem-bryonic antigen and carbohydrate antigen 153(CA153)were detected by flow cytometry and chemiluminescence immunoassay before and after treatment,respectively.The quality of life of the two groups before and after treatment was evaluated according to the Quality of life of Chemobiological Therapy scale for Cancer patients in China(QLQ-CCC).The adverse reactions during treatment and the overall survival rate of the two groups after 1-year follow-up were recorded.Results The disease control rate of the observation group was higher than that of the control group[95.0％(38/40)vs 77.5％(31/40)](P=0.023).Before treatment,there were no significant differences in the levels of immune indexes,carcinoembryonic antigen and CA153 between the two groups(all P＞0.05).After treatment,the level of CD8+cells in the observation group was lower than that in the control group,while the levels of CD4+,CD3+cells and CD4+/CD8+ratio were higher than those in the control group(all P＜0.05).After treatment,the levels of CEA and CA153 in the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group(all P＜0.05).After treatment,the QLQ-CCC scores of the two groups were significantly higher than those before treatment,and that in the observation group was significantly higher than that in the control group[(83±9)vs(72±8)](all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.157).At the end of follow-up in May 2025,the survival rate of the observation group was 95.0％(38/40),and the survival rate of the control group was 77.5％(31/40).There was statistically significant difference in the survival curve between the two groups(Log-rank x2=5.165,P=0.023).Conclusion Paclitaxel for injection(albumin-bound)combined with pyrotinib in the treatment of HER-2 positive breast cancer with lung metastasis has a significant effect,which can effectively regulate cellular immune function,reduce serum tumor marker levels,improve the quality of life of patients,improve the prognosis of patients,and the adverse reactions can be managed and tolerated,with good safety.