Application, efficacy and potential risks of neratinib/neratinib in breast cancer treatment

Neratinib/Neratinib is a therapeutic oral drug that inhibits HER1, HER2 and HER4 (human epidermal growth factor receptor) in a covalent and irreversible manner. In the field of breast cancer treatment, neratinib has demonstrated its unique therapeutic value.

For patients with HER2-positive breast cancer, whether in early, late or metastatic stages, neratinib can be used as an effective single treatment. What's more, when neratinib is combined with standard therapy, it improves pathological complete response rates in patients with HER2-positive, hormone receptor-negative breast cancer. In a phase I/II clinical trial, the combination of neratinib and capecitabine demonstrated systemic efficacy in patients with metastatic HER2-positive breast cancer.

InNEFERT-T trial, compared with the control group treated with paclitaxel combined, the central nervous system (CNS) recurrence rate of patients in the combined treatment group of neratinib and paclitaxel was significantly reduced, and the time to brain metastasis was prolonged. This finding hints at a possible positive role for neratinib in preventing brain metastases from breast cancer. However, results from another phase II trial showed that neratinib as monotherapy did not perform well in terms of objective response rate in the CNS. Therefore, although neratinib monotherapy has shown certain efficacy, its therapeutic effect in combination with other drugs in patients with brain metastases from HER2-positive breast cancer still needs to be further explored.

Of course, like other drugs, the use of neratinib is also accompanied by certain side effects. Patients may experience common adverse reactions such as nausea, vomiting, diarrhea, abdominal pain, fatigue and rash during use. In addition, neratinib may induce severe cardiotoxic reactions, including arrhythmias and myocardial damage.