title: A phase II study of lapatinib monotherapy in chemotherapy-refractory HER2-positive and HER2-negative advanced or metastatic breast cancer.
abstract: BACKGROUND
  The efficacy and tolerability of the epidermal growth factor receptor/human epidermal growth factor receptor type 2 (HER2) tyrosine kinase inhibitor lapatinib in refractory metastatic breast cancer were assessed.
  
  
  METHODS
  In a phase II, open-label study, patients with previously treated HER2-positive (n = 140) or HER2-negative (n = 89) metastatic breast cancer received once-daily oral lapatinib 1500 mg/day.
  
  
  RESULTS
  Most (76%) patients had received four or more lines of prior therapy. The response rate in the HER2-positive cohort was 4.3% by investigator assessment and 1.4% by independent assessment. Both assessments established that approximately 6% of HER2-positive patients derived clinical benefit from lapatinib, being progression free for >/=6 months. No objective tumor responses occurred in the HER2-negative cohort. Independent review assessments of median time to progression and median progression-free survival were similar in the HER2-positive and HER2-negative cohorts (9.1 and 7.6 weeks, respectively). All responders exhibited HER2 overexpression (3+ by immunohistochemistry), and five of six responders were HER2 amplified by FISH. Lapatinib-related adverse events, including diarrhea (54%), rash (30%), and nausea (24%), were primarily mild to moderate in severity.
  
  
  CONCLUSIONS
  Lapatinib monotherapy had modest clinical activity in HER2-positive metastatic breast cancer that progressed on prior trastuzumab regimens. No apparent clinical activity was observed in chemotherapy-refractory, HER2-negative disease.
authors.affiliation: Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA. hburstein@partners.org
authors.forename: H J
authors.initials: HJ
authors.lastname: Burstein
authors.forename: A M
authors.initials: AM
authors.lastname: Storniolo
authors.forename: S
authors.initials: S
authors.lastname: Franco
authors.forename: J
authors.initials: J
authors.lastname: Forster
authors.forename: S
authors.initials: S
authors.lastname: Stein
authors.forename: S
authors.initials: S
authors.lastname: Rubin
authors.forename: V M
authors.initials: VM
authors.lastname: Salazar
authors.forename: K L
authors.initials: KL
authors.lastname: Blackwell
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000556:secondary; D005260:Female; D018734:Genes, erbB-2; D006801:Humans; D000077341:Lapatinib; D008875:Middle Aged; D011799:Quinazolines / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000077341:Lapatinib