Treatment of HER2-Positive Brain Metastasis from Cervical Cancer Using Multimodal Therapy Including Pyrotinib: A Case Report

Cervical cancer with brain metastasis is uncommon and generally associated with poor prognosis. Overexpression of human epidermal growth factor receptor 2 (HER2) represents a promising therapeutic target in gynecological malignancies. We report a patient with International Federation of Gynaecology and Obstetrics (FIGO) stage IVb cervical adenosquamous carcinoma who developed a solitary brain metastasis following chemoradiotherapy. She underwent surgical resection, and immunohistochemistry of the postoperative specimen demonstrated HER2 overexpression (3+). Postoperatively, she received radiotherapy and systemic therapy with pyrotinib and capecitabine, achieving a complete response with manageable toxicity. Her progression-free survival was nearly 29 months (from brain metastasis resection to last follow-up). This case illustrates successful management of HER2-positive brain metastases from cervical cancer using a multimodal approach combining surgery, radiotherapy, and systemic therapy with pyrotinib and capecitabine. The durable complete response with manageable toxicity underscores the therapeutic potential of HER2-targeted therapy as part of a multimodal regimen; however, further studies are required to validate these findings and optimize personalized treatment strategies.