title: Current standards in the treatment of metastatic breast cancer with focus on Lapatinib: a review by a Central European Consensus Panel.
abstract: In breast cancer, early detection as well as new developments in therapeutic options has resulted in less patients presenting with metastatic disease. However, about one-third of women with early stage breast cancer will eventually develop metastatic disease. Furthermore, approximately 20-30% of patients with breast cancer have tumors that overexpress human epidermal growth factor receptor (HER-2), which is associated with an aggressive tumor phenotype and poor prognosis. The identification of the HER-2 protein led to the development of highly effective therapeutics directed at this receptor. Trastuzumab, a recombinant, humanized, monoclonal antibody that binds to the extracellular domain of the HER-2 protein, has shown significant clinical benefit in metastatic and early-stage HER-2-positive breast cancer. Since the cancer recurs after adjuvant therapy in some women, and metastatic breast cancer eventually develops resistance to trastuzumab, there is a need for alternative treatment modalities to block HER-2 signaling. One of these treatment options is lapatinib, an orally active small molecule that inhibits the tyrosine kinases of HER-2 and the epidermal growth factor receptor type 1 (EGFR). In this consensus statement current treatment options in metastatic and locally advanced disease are discussed with a special focus on lapatinib.
authors.affiliation: Klinische Abteilung für Onkologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Austria. guenther.steger@meduniwien.ac.at
authors.forename: Guenther G
authors.initials: GG
authors.lastname: Steger
authors.forename: Jitka
authors.initials: J
authors.lastname: Abrahámová
authors.forename: Florin
authors.initials: F
authors.lastname: Bacanu
authors.forename: Stephen
authors.initials: S
authors.lastname: Brincat
authors.forename: Arija
authors.initials: A
authors.lastname: Brize
authors.forename: Alvydas
authors.initials: A
authors.lastname: Cesas
authors.forename: Tanja
authors.initials: T
authors.lastname: Cufer
authors.forename: Magdolna
authors.initials: M
authors.lastname: Dank
authors.forename: Renata
authors.initials: R
authors.lastname: Duchnowska
authors.forename: Alexandru
authors.initials: A
authors.lastname: Eniu
authors.forename: Jacek
authors.initials: J
authors.lastname: Jassem
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kahán
authors.forename: Erika
authors.initials: E
authors.lastname: Matos
authors.forename: Peeter
authors.initials: P
authors.lastname: Padrik
authors.forename: Signe
authors.initials: S
authors.lastname: Plāte
authors.forename: Helis
authors.initials: H
authors.lastname: Pokker
authors.forename: Gunta
authors.initials: G
authors.lastname: Purkalne
authors.forename: Constanta
authors.initials: C
authors.lastname: Timcheva
authors.forename: Valentina
authors.initials: V
authors.lastname: Tzekova
authors.forename: Rostislav
authors.initials: R
authors.lastname: Vyzula
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
mesh_terms: D000465:Algorithms; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016503:Drug Delivery Systems; D004359:Drug Therapy, Combination; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005060:Europe; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D006801:Humans; D000077341:Lapatinib; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000473:pathology; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
chemical_list: D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C512478:EGFR protein, human; C508053:ERBB2 protein, human