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Esranur Aydın: Some cases change the way we think about treatment

Esranur Aydın/LinkedIn

Jan 30, 2025, 09:16

Esranur Aydın: Some cases change the way we think about treatment

Esranur Aydın, Clinical Cancer Molecular Biologist at Medicana Sağlık Grubu, Istanbul, shared an article on LinkedIn she and her colleagues authored:

“Some cases change the way we think about treatment.

We just published a fascinating case in Frontiers in Oncology – one that challenged our understanding of resistance in HR+/HER2+ metastatic breast cancer and pushed us to rethink therapeutic strategies.

This patient initially had a near-complete response to transtuzumab deruxtecan (T-DXd) when HER2 IHC was positive. But when the disease progressed and HER2 IHC turned negative, we were faced with a tough question: What Next?

Through molecular tumor board (MTB) discussions, we pursued a neratinib + fulvestrant + paclitaxel combination – and once again saw a near-complete response. This case sheds light on potential new resistance mechanisms to T-DXd and raises important questions about the role of HER2-targeted therapy in tumors that remain HER2-driven at the molecular level.

Most importantly, it reinforces something we’ve seen time and again: Precision oncology is dynamic. Real-time treatment decisions, based on evolving molecular data, can make a real difference in patient outcomes.

A huge thanks to our mentor Prof. Dr. Mutlu Demiray for leading this work and to first author Ünal Metin Tokat for his incredible contributions. I’m also grateful to our entire team Eylul Ozgu, Şevval Nur Bilgiç, and Ashkan Adibi for their dedication – people like these are what make this field so exciting!

If you’re working on similar cases, I’d love to hear your thoughts!

Read the full paper here.”

Case report: Near-complete response to neratinib-based treatment in HR-positive HER2-amplified metastatic breast cancer refractory to trastuzumab deruxtecan

Authors: Ünal Metin Tokat et al.

Treatment