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Neratinib plus capecitabine for the treatment of advanced HER2-positive breast cancer

Mafalda Oliveira1,2, Laia Garrigós1,2, Juan David Assaf1

  • 1Medical Oncology Department, Vall d'Hebron Hospital , Barcelona, Spain.

Expert Review of Anticancer Therapy
|September 1, 2020
PubMed
Abstract

Insights

Neratinib plus capecitabine offers a valid treatment option for advanced HER2-positive breast cancer patients who have progressed on prior therapies. This combination demonstrated improved progression-free survival and delayed central nervous system disease progression.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced HER2-positive breast cancer has several emerging treatment options.
  • Neratinib is an irreversible pan-HER tyrosine kinase inhibitor (TKI).
  • The NALA trial compared neratinib plus capecitabine to lapatinib plus capecitabine.

Purpose of the Study:

  • To review preclinical and clinical data of neratinib plus capecitabine.
  • To summarize efficacy and safety from Phase I/II and III trials.
  • To position this regimen within the treatment landscape for HER2-positive metastatic breast cancer.

Main Methods:

  • Analysis of preclinical and clinical data.
  • Summarization of efficacy and safety results from multiple trials.
  • Discussion of the regimen in the context of treatment progression.

Main Results:

  • Neratinib plus capecitabine showed increased progression-free survival (PFS).
  • The combination improved time to intervention for central nervous system disease.
  • Diarrhea was the primary adverse event associated with neratinib.

Conclusions:

  • Neratinib plus capecitabine is a viable option for advanced HER2-positive breast cancer after two prior anti-HER2 regimens.
  • Further research into predictive biomarkers for neratinib efficacy is warranted.
  • Managing side effects like diarrhea with prophylactic treatment is crucial.
Keywords:
CNS diseaseHER2-positive metastatic breast cancercapecitabineneratinib

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