Current standards in the treatment of metastatic breast cancer with focus on Lapatinib: a review by a Central European Consensus Panel.
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.
Steger
Guenther G
GG
Klinische Abteilung für Onkologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Austria. guenther.steger@meduniwien.ac.at
Abrahámová
Jitka
J
Bacanu
Florin
F
Brincat
Stephen
S
Brize
Arija
A
Cesas
Alvydas
A
Cufer
Tanja
T
Dank
Magdolna
M
Duchnowska
Renata
R
Eniu
Alexandru
A
Jassem
Jacek
J
Kahán
Zsuzsanna
Z
Matos
Erika
E
Padrik
Peeter
P
Plāte
Signe
S
Pokker
Helis
H
Purkalne
Gunta
G
Timcheva
Constanta
C
Tzekova
Valentina
V
Vyzula
Rostislav
R
Zielinski
Christoph C
CC
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
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