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Pyrotinib + trastuzumab + nab-paclitaxel is a combination therapeutic regimen being investigated for the treatment of HER2-positive metastatic breast cancer with brain metastases. The regimen consists of pyrotinib, an orally bioavailable, irreversible pan-ErbB tyrosine kinase inhibitor (TKI) targeting HER2, EGFR, and HER4; trastuzumab, a recombinant humanized monoclonal antibody that targets the extracellular domain of the HER2 protein; and nab-paclitaxel (Abraxane), an albumin-bound nanoparticle formulation of the microtubule inhibitor paclitaxel. This combination is specifically being studied in a Phase 2 clinical trial led by the Shandong Cancer Hospital and Institute to evaluate its intracranial and extracranial efficacy in patients with HER2-positive breast cancer that has metastasized to the central nervous system. The triplet approach aims to overcome resistance and improve blood-brain barrier penetration through the small-molecule TKI component while maintaining systemic control with the antibody and chemotherapy components.
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