Improved outcome with Lapatinib plus Capecitabine in HER2 positive metastatic breast cancer

الملخص EN

Background &Objective: Lapatinib is a dual tyrosine kinase inhibitor blocking human epidermal growth factor receptors (HER1, HER2).

Lapatinib in combination with Capecitabine has showed efficacy in HER2+ metastatic breast cancer (MBC) previously treated with Anthracycline, Taxens and Trastuzumab.

This study is the first to evaluate the clinical benefit and safety of the combination of Lapatinib and Capecitabine in HER2+ MBC previously treated with anthracycline, taxane and trastuzumab, treated at Albairouni cancer center.

Methods & Material: Patients with HER2 Positive, hormonal receptors negative, locally advanced or metastatic breast cancer that had failed anthracycline, a taxane, and trastuzumab were enrolled.

Patients received (lapatinib 1250 mg per day continuously plus capecitabine 2000 mg/m2 on days 1 through 14 of a 21-day cycle).

Treatment was given until progression.

The primary end point was the clinical benefit (complete response, partial response or stability) for at least 3 months.

Results: In the 60 evaluated patients, Clinical benefit rate was documented in 76% and 58.32% of the study population for 3 and 6 moths, respectively.

Progression beyond one year was seen in 15 pts (25%).

Interestingly, one patient achieved time to progression (TTP) >24 months.

Median TTP was 8.1 months [95% CI: 6.5-11.2].

The most clinical side effects were mild: nausea (40%), vomiting (20%), diarrhea (35%), hand-foot syndrome (41.7%), rash (15%) and fatigue (11.66%).

Conclusion: The combination of Lapatinib and Capecitabine demonstrated a broad clinical benefit with acceptable safety profile in pretreated HER2+ metastatic breast cancer with either visceral or brain metastases.