# Comprehensive management of chest wall recurrent HER2-positive breast cancer with Anlotinib and hypofractionated radiotherapy: a case report

**Authors:** Jing Xu, Qing Liu, Yue Yin, Guanglu Dong

PMC · DOI: 10.3389/fonc.2025.1708884 · Frontiers in Oncology · 2026-01-05

## TL;DR

A patient with resistant HER2-positive breast cancer showed significant tumor shrinkage after treatment with Anlotinib and hypofractionated radiotherapy.

## Contribution

This case report presents a novel treatment approach using Anlotinib and HFRT for Trastuzumab-resistant HER2-positive breast cancer.

## Key findings

- The tumor showed considerable shrinkage after one cycle of Anlotinib and hypofractionated radiotherapy.
- The patient remains in remission following the combined therapy.
- The treatment may be a promising option for Trastuzumab-resistant HER2-positive breast cancer.

## Abstract

HER2-positive breast cancer (BC) patients who have developed resistance to various systemic therapies face limited treatment alternatives. Literature on Anlotinib combined with hypofractionated radiotherapy (HFRT) for recurrent/metastatic HER2-positive BC is scarce, particularly for Trastuzumab-resistant cases. This report describes an unresectable, bulky HER2-positive BC recurrence in a patient who had an inadequate response to multiple systemic treatments, including chemotherapy, Trastuzumab, immunotherapy, and conventional fractionated radiotherapy (CFRT). Upon observing further progression of the chest wall mass, we initiated a treatment regimen that combined Anlotinib with HFRT. Remarkably, after just one cycle of this combined therapy, the tumor exhibited considerable shrinkage, with the patient now remaining in remission. These findings indicate that Anlotinib, in conjunction with HFRT, may be a promising option for patients with unresectable chest wall recurrence(CWR), particularly for those who have previously undergone Trastuzumab therapy but subsequently developed resistance.

## Linked entities

- **Proteins:** ERBB2 (erb-b2 receptor tyrosine kinase 2)
- **Chemicals:** Anlotinib (PubChem CID 25017411)
- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Genes:** TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, VEGFA (vascular endothelial growth factor A) [NCBI Gene 7422] {aka L-VEGF, MVCD1, VEGF, VPF}, KDR (kinase insert domain receptor) [NCBI Gene 3791] {aka CD309, FLK1, VEGFR, VEGFR2}, PIK3CB (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta) [NCBI Gene 5291] {aka P110BETA, PI3K, PI3KBETA, PIK3C1}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, EREG (epiregulin) [NCBI Gene 2069] {aka EPR, ER, Ep}, PGR (progesterone receptor) [NCBI Gene 5241] {aka NR3C3, PR}, PDGFRB (platelet derived growth factor receptor beta) [NCBI Gene 5159] {aka CD140B, IBGC4, IMF1, JTK12, KOGS, OPDKD}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, TXK (TXK tyrosine kinase) [NCBI Gene 7294] {aka BTKL, PSCTK5, PTK4, RLK, TKL}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, HIF1A (hypoxia inducible factor 1 subunit alpha) [NCBI Gene 3091] {aka HIF-1-alpha, HIF-1A, HIF-1alpha, HIF1, HIF1-ALPHA, MOP1}, KIT (KIT proto-oncogene, receptor tyrosine kinase) [NCBI Gene 3815] {aka C-Kit, CD117, MASTC, PBT, SCFR}, RAD51 (RAD51 recombinase) [NCBI Gene 5888] {aka BRCC5, FANCR, HRAD51, HsRad51, HsT16930, MRMV2}, TFAP2C (transcription factor AP-2 gamma) [NCBI Gene 7022] {aka AP2-GAMMA, ERF1, TFAP2G, hAP-2g}
- **Diseases:** PD (MESH:D018450), positive (MESH:D000377), necrotic (MESH:D009336), lesion (MESH:D009059), hypertriglyceridemia (MESH:D015228), breast mass (MESH:D061325), BC (MESH:D001943), hypercholesterolemia (MESH:D006937), heart disease (MESH:D006331), mastectomy (MESH:D000072656), telangiectasia (MESH:D013684), pleural effusion (MESH:D010996), diabetes (MESH:D003920), hand-foot syndrome (MESH:D060831), metastases (MESH:D009362), IDC (MESH:D044584), BED (MESH:D021081), hypoxia (MESH:D000860), chest wall lesion (MESH:D002637), hypothyroidism (MESH:D007037), hypoxic (MESH:D002534), Cancer (MESH:D009369), lipomas (MESH:D008067), cytotoxic (MESH:D064420), lymph node metastasis (MESH:D008207), keloids (MESH:D007627), SCLC (MESH:D055752), rash (MESH:D005076), breast pain (MESH:D059373), nipple discharge (MESH:C000626393), skin ulceration (MESH:D012883), NSCLC (MESH:D002289), cutaneous adverse effects (MESH:D013262), desquamation (MESH:D017490), hypertension (MESH:D006973)
- **Chemicals:** Anlotinib (MESH:C000625192), Carboplatin (MESH:D016190), Toripalimab (MESH:C000656314), alcohol (MESH:D000438), oxygen (MESH:D010100), AC (MESH:D000186), CFRT (-), Doxorubicin (MESH:D004317), paclitaxel (MESH:D017239), bevacizumab (MESH:D000068258), Trastuzumab (MESH:D000068878), Cyclophosphamide (MESH:D003520), FDG (MESH:D019788)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** MCF-7 — Homo sapiens (Human), Invasive breast carcinoma of no special type, Cancer cell line (CVCL_0031)

## Full text

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## Figures

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## References

38 references — full list in the complete paper: https://tomesphere.com/paper/PMC12812643/full.md

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Source: https://tomesphere.com/paper/PMC12812643