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Response to Pyrotinib in a Chinese Patient with Bone-Metastatic Scrotal Paget’s Disease Harboring Triple Uncommon HER2 Mutation: A Case Report

Authors Guo JJ, Jiao XD, Wu Y, Qin BD, Liu K, Zang YS

Received 5 January 2020

Accepted for publication 26 February 2020

Published 30 June 2020 Volume 2020:13 Pages 6289—6293

DOI https://doi.org/10.2147/OTT.S244814

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Nicola Silvestris


Jin-Ju Guo,1,2,* Xiao-Dong Jiao,1,* Ying Wu,1,* Bao-Dong Qin,1 Ke Liu,1 Yuan-Sheng Zang1

1Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, Shanghai 200072, People’s Republic of China; 2Department of Medical Oncology, People’s Hospital of Qianshan County, Jiangxi 334500, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yuan-Sheng Zang
Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, 64 Hetian Road, Shanghai 200072, People’s Republic of China
Tel/ Fax +86 21-66540109-8039
Email doctorzangys@163.com

Background: Previous studies have suggested the efficacy of HER2 antibody (trastuzumab) in scrotal Paget’s disease with HER2 amplification or overexpression. However, no report about the effectiveness of HER2 inhibitor (pyrotinib) in those patients has been provided until now.
Case Presentation: We present a case of a Chinese patient with bone-metastatic scrotal Paget’s disease harboring triple uncommon HER2 mutations (R678Q/S310Y/S310F). Due to poor conditions (severe anemia, thrombocytopenia, ECOG PS3), this patient could not tolerate traditional chemotherapy and radiotherapy. Then, the patient participated in a registered clinical trial (NCT03239015) about basket trial for intractable cancer. The patient received pyrotinib (400 mg po qd) and achieved a partial response for 4.0 months.
Conclusion: This is the first report describing a patient with scrotal Paget’s disease harboring triple uncommon HER2 mutation who responds well to pyrotinib. This case suggested that HER2 mutation is also a potential biomarker for treatment in extramammary Paget’s disease and pyrotinib may be an ideal choice for these patients.

Keywords: Paget’s disease, extramammary Paget’s disease, HER2, pyrotinib

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