Is it effective to take neratinib/neratinib after dual targeting of breast cancer?

Neratinib/Neratinib is an oral drug that is a tyrosine kinase inhibitor (TKI). It is mainly used for the treatment of breast cancer, especially HER2-positive breast cancer. Dual-targeted therapy for breast cancer often uses a combination of drugs, including HER2 receptor inhibitors and tyrosine kinase inhibitors. If the patient has already received dual-targeted therapy for breast cancer, neratinib may be a suitable option.

Neratinib is an irreversible panHER inhibitor that is not only more effective than lapatinib (Lapatinib), but can also increase trastuzumab (trastuzumab)-mediated cytotoxicity (ADCC) . Preclinical studies have shown that neratinib induces cell cycle arrest and proliferation inhibition in HER2-expressing cells. In the exteNET clinical trial, neratinib was 73% effective in patients with HER2+ metastatic breast cancer who had previously received adjuvant or neoadjuvant trastuzumab, but on the other hand, it exhibited high toxicity, leading to dose reductions and adverse events, the most commonly reported of which was diarrhea. When tested in patients with early-stage HER2+ breast cancer, the results were as promising as in advanced cases, as neratinib showed improvements in disease-free survival.

Neratinib is currently being tested in combination with other therapies such asT-DM1 and fulvestrant. Regarding brain metastases, trials such as NEfERT-T, NALA and TBCRC 022 have shown that neratinib can reduce the incidence of central nervous system events. In light of these clinical trial results, neratinib is well tolerated; however, whether neratinib is suitable for use requires physician evaluation.