EAS Publisher | Double HER2 Blockade and Iatrogenic Hypothyroidism During Treatment of HER2-Positive Metastatic Breast Cancer: A Clinical Case and Literature Review

Double HER2 Blockade and Iatrogenic Hypothyroidism During Treatment of HER2-Positive Metastatic Breast Cancer: A Clinical Case and Literature Review

DOI : https://doi.org/10.36349/easjms.2025.v07i05.006

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Abstract: HER2-positive metastatic breast cancer represents a significant therapeutic challenge. Its prognosis has been altered thanks to significant advances in targeted anti-HER2 therapies. These treatments, such as trastuzumab and pertuzumab, have significantly improved the management of this pathology, enhancing patient survival, but are also responsible for adverse effects. Hypothyroidism, although less frequent than other complications, is an important side effect to recognize and manage. This clinical case presents a 47-year-old patient with HER2-positive metastatic breast cancer treated with chemotherapy combined with a dual anti-HER2 blockade using trastuzumab and pertuzumab, along with letrozole. After 52 cycles of dual blockade, the patient developed overt hypothyroidism. Levothyroxine replacement therapy improved her symptoms. This case illustrates the clinical importance of endocrine monitoring in patients receiving targeted anti-HER2 therapies, highlighting the need for a multidisciplinary approach to optimize the management of adverse effects and the quality of life of patients. A diagnostic delay of hypothyroidism can potentially impact the prognosis of the disease.

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