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Dual Anti-HER2 Combination with Chemotherapy as First-line Treatment for HER2-positive Metastatic Breast Cancer

ACTA MEDICA INDONESIANA · Vol. 57 No. 4 (2025)

ISSN
2338-2732, 0125-9326
Terbit
2025-12-23
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

HER2-positive metastatic breast cancer is an aggressive subtype of breast cancer associated with poor prognosis due to high recurrence and mortality rates. The introduction of dual anti-HER2 therapy combined with chemotherapy has significantly improved treatment outcomes. A 50-year-old woman with a history of left mastectomy in 2019 who initially declined adjuvant chemotherapy and radiotherapy. Three years later, she presented to the clinic with erythematous skin changes, a nodule at the mastectomy site, and left-arm lymphedema. A biopsy confirmed recurrent HER2-positive breast cancer with metastases to lymph nodes, liver, and bones (cT4cN3cM1 ER−, PR−, HER2+). She received initial treatment with dual anti-HER2 (Pertuzumab, Trastuzumab) and Docetaxel every 3 weeks for six cycles, followed by maintenance therapy with Pertuzumab and Trastuzumab. PET scan evaluations showed an excellent response, with complete resolution of the primary lesion and substantial regression of metastases. The CLEOPATRA trial supports the efficacy of a combination of dual anti-HER2 and Docetaxel, showing prolonged progression-free and overall survival. The combination of dual anti-HER2 enhanced antitumor efficacy by providing dual inhibition of HER2. This case highlights the pivotal role of dual anti-HER2 therapy combined with chemotherapy in improving survival outcomes of patients with metastatic HER2-positive breast cancer.

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  • State University of Semarang
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Dimas PriantonoAfiliasi tidak diketahui2
Eko FaridaState University of Semarang1
Zulkifli AminAfiliasi tidak diketahui1
Vito Filbert JayalieAfiliasi tidak diketahui1
Kurniadi HusodoAfiliasi tidak diketahui1
Achmad Fauzi KamalAfiliasi tidak diketahui1
Heru WidyawarmanAfiliasi tidak diketahui1
Errol Untung HutagalungAfiliasi tidak diketahui1
Noviana JoenputriAfiliasi tidak diketahui1
Hamzah ShatriAfiliasi tidak diketahui1
Jane A.C. DjianzonieAfiliasi tidak diketahui1
Livy B PratisthitaAfiliasi tidak diketahui1
Rahmad MulyadiAfiliasi tidak diketahui1
Gurmeet SinghAfiliasi tidak diketahui1
Calvin Kurnia MulyadiAfiliasi tidak diketahui1
Vitya ChandikaAfiliasi tidak diketahui1
Maria PyrhadistyaAfiliasi tidak diketahui1
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Handy Nugraha PutraAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Dual Anti-HER2 Combination with Chemotherapy as First-line Treatment for HER2-positive Metastatic Breast Cancer</dc:title>
	<dc:creator>Rajabto, Wulyo</dc:creator>
	<dc:creator>Brahma, Bayu</dc:creator>
	<dc:creator>Putri, Rizky Ifandriani</dc:creator>
	<dc:creator>Indrawati, Hapsari</dc:creator>
	<dc:creator>Safitri, Ainun</dc:creator>
	<dc:subject xml:lang="en-US">anti-HER2</dc:subject>
	<dc:subject xml:lang="en-US">chemotherapy</dc:subject>
	<dc:subject xml:lang="en-US">metastatic</dc:subject>
	<dc:subject xml:lang="en-US">HER2-positive</dc:subject>
	<dc:subject xml:lang="en-US">breast cancer</dc:subject>
	<dc:description xml:lang="en-US">HER2-positive metastatic breast cancer is an aggressive subtype of breast cancer associated with poor prognosis due to high recurrence and mortality rates. The introduction of dual anti-HER2 therapy combined with chemotherapy has significantly improved treatment outcomes. 
A 50-year-old woman with a history of left mastectomy in 2019 who initially declined adjuvant chemotherapy and radiotherapy. Three years later, she presented to the clinic with erythematous skin changes, a nodule at the mastectomy site, and left-arm lymphedema. A biopsy confirmed recurrent HER2-positive breast cancer with metastases to lymph nodes, liver, and bones (cT4cN3cM1 ER−, PR−, HER2+). She received initial treatment with dual anti-HER2 (Pertuzumab, Trastuzumab) and Docetaxel every 3 weeks for six cycles, followed by maintenance therapy with Pertuzumab and Trastuzumab. PET scan evaluations showed an excellent response, with complete resolution of the primary lesion and substantial regression of metastases. The CLEOPATRA trial supports the efficacy of a combination of dual anti-HER2 and Docetaxel, showing prolonged progression-free and overall survival. The combination of dual anti-HER2 enhanced antitumor efficacy by providing dual inhibition of HER2. This case highlights the pivotal role of dual anti-HER2 therapy combined with chemotherapy in improving survival outcomes of patients with metastatic HER2-positive breast cancer. </dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-12-23</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2971</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 4 (2025): Acta Medica Indonesiana; 538</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2971/839</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Wulyo Rajabto, Bayu Brahma, Rizky Ifandriani Putri, Hapsari Indrawati, Ainun Safitri</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>