Lapatinib plus trastuzumab in pretreated human epidermal growth factor receptor 2-positive metastatic breast cancer

• Published in: Journal of cancer research and therapeutics 2014-10, Vol.10 (4), p.967-972
• Main Authors: Sotelo, Miguel J, García-Sáenz, Jose Angel, Manso, Luis, Moreno, Fernando, Ciruelos, Eva, Callata, Hector R, Mendiola, Cesar, Cabezas, Santiago, Ghanem, Ismael, Díaz-Rubio, Eduardo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Cancer metastasis; Diagnosis; Disease-Free Survival; Dosage and administration; Drug Administration Schedule; Drug therapy; Epidermal growth factor receptors; Female; Health aspects; Humans; Lapatinib; Middle Aged; Neoplasm Metastasis; Quinazolines - administration & dosage; Quinazolines - adverse effects; Receptor, ErbB-2 - metabolism; Retrospective Studies; Trastuzumab; Trastuzumab - administration & dosage; Trastuzumab - adverse effects; Treatment Outcome
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/0973-1482.138017

Dual human epidermal growth factor receptor 2 (HER2) blockade has been preclinically and clinically assessed in HER2-overexpressing metastatic breast cancer (mBC) with encouraging results. This is a descriptive retrospective study of trastuzumab plus lapatinib activity in patients with HER2-overexpressing mBC from two centers. The primary endpoints were to assess objective response rate (ORR) and toxicity. The secondary endpoints were to assess progression-free survival (PFS) and overall survival. A total of 23 HER2-positive mBC patients previously treated with trastuzumab received a trastuzumab plus lapatinib based therapy. Chemotherapy (CT) was added to the dual HER2 blockade treatment in 13 patients (56%), whereas hormonotherapy (HT) was added in 8 patients (35%) and 2 patients (9%) received lapatinib plus trastuzumab without any other agent. ORR was 22% (5/23) and 39% (9/23) of patients had stable disease. PFS in the overall population was 4 months. PFS in patients with CT was 5 months, whereas PFS in patients with HT was 2 months. Grade≥3 adverse events were diarrhea (26%) and hand-and-foot syndrome (9%). These findings suggest that dual HER2 blockade in combination with CT is feasible in pretreated HER2-positive mBC patients.