Lapatinib plus trastuzumab in pretreated human epidermal growth factor receptor 2-positive metastatic breast cancer
Miguel J Sotelo1, Jose Angel García-Sáenz, Luis Manso
1Department of Medical Oncology, Hospital Universitario Clínico San Carlos, Spain.
Background:
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.
Patients And Methods:
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.
Results:
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%).
Conclusions:
These findings suggest that dual HER2 blockade in combination with CT is feasible in pretreated HER2-positive mBC patients.
Insights
Dual HER2 blockade with trastuzumab and lapatinib showed feasibility in pretreated metastatic breast cancer patients. Combination with chemotherapy improved progression-free survival, suggesting a viable treatment option.
Area of Science:
- Medical Oncology
- Clinical Research
- Breast Cancer Therapeutics
Background:
- Dual human epidermal growth factor receptor 2 (HER2) blockade is a promising strategy for HER2-overexpressing metastatic breast cancer (mBC).
- Previous studies have shown encouraging preclinical and clinical results for dual HER2 blockade in mBC.
Purpose of the Study:
- To evaluate the activity and toxicity of trastuzumab plus lapatinib in patients with HER2-overexpressing mBC.
- To assess objective response rate (ORR), progression-free survival (PFS), and overall survival.
Main Methods:
- Retrospective study of 23 HER2-positive mBC patients previously treated with trastuzumab.
- Patients received trastuzumab plus lapatinib, with or without chemotherapy (CT) or hormonotherapy (HT).
- Primary endpoints: ORR and toxicity. Secondary endpoints: PFS and overall survival.
Main Results:
- Objective response rate (ORR) was 22% (5/23); 39% had stable disease.
- Median PFS was 4 months overall, 5 months with CT, and 2 months with HT.
- Grade ≥3 adverse events included diarrhea (26%) and hand-and-foot syndrome (9%).
Conclusions:
- Dual HER2 blockade with trastuzumab and lapatinib is feasible in pretreated HER2-positive mBC patients.
- Combination with chemotherapy demonstrated improved PFS.
- This approach represents a potential treatment option for this patient population.
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