Which is better, T-DM1 or pyrotinib?

Dec 03, 2025 Source: Cainiu Health

Dr. Li Feng

Introduction

T-DM1 generally refers to trastuzumab. Trastuzumab and pyrotinib do not have absolute advantages or disadvantages over each other; the choice depends on the patient's disease stage, treatment history, and physical condition. Trastuzumab is a foundational treatment for HER2-positive tumors, while pyrotinib shows significant benefits in cases of recurrence, metastasis, or combination therapy. If drug-related adverse effects or changes in病情 occur,

T-DM1 generally refers to trastuzumab. There is no absolute superiority between trastuzumab and pyrotinib; the choice depends on the patient's disease stage, treatment history, and overall health status. Trastuzumab is a foundational therapy for HER2-positive tumors, while pyrotinib shows clear advantages in cases of recurrence, metastasis, or combination therapy. If medication-related discomfort or changes in condition occur, timely medical evaluation and treatment adjustments are recommended.

Trastuzumab is a large-molecule monoclonal antibody administered via intravenous infusion. It is indicated for adjuvant treatment of HER2-positive breast cancer, as well as first-line treatment for metastatic breast cancer and gastric cancer. It precisely binds to the HER2 receptor to inhibit tumor proliferation, with well-established clinical use and coverage by medical insurance.

Pyrotinib is an oral small-molecule irreversible inhibitor that targets both HER2 and EGFR. In combination with chemotherapy, it is used for recurrent or metastatic breast cancer in patients previously treated, and can also be part of first-line combination therapy. Its oral administration offers convenience and may remain effective in patients with drug resistance.

During treatment, patients must strictly follow medical instructions regarding dosage and timing. Cardiac function should be monitored during trastuzumab therapy, while management of side effects such as diarrhea is important when using pyrotinib. Maintaining regular作息 (daily routines) and a balanced diet, along with periodic monitoring of relevant indicators, is essential to ensure therapeutic efficacy.

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