Clinical outcome of patients with brain metastases from HER2-positive breast cancer treated with lapatinib and capecitabine.
BACKGROUND
In the present study, we investigated the clinical outcome of patients with brain metastases (BMs) from human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) treated with lapatinib and capecitabine (LC).


METHODS
Of 81 HER2+ metastatic BC patients treated with LC at two Italian institutions, 30 patients with BMs eligible for the analysis were identified. All patients were pretreated with trastuzumab for metastatic disease. No patients had received prior lapatinib and/or capecitabine.


RESULTS
Median age was 45 years (range 24-75) and 26 of 30 patients (86.7%) had received prior cranial radiotherapy. In the 22 patients with BMs evaluable for response, 7 partial responses (31.8%) and 6 disease stabilizations (27.3%) were observed. Overall, the median brain-specific progression-free survival was 5.6 months (95% confidence interval 4.4-6.8). Patients treated with LC had a median overall survival (from the time of development of BMs) significantly longer compared with 23 patients treated with trastuzumab-based therapies only beyond brain progression (27.9 months versus 16.7 months, respectively, P = 0.01).


CONCLUSIONS
LC is active for BMs from HER2+ BC in patients not pretreated with either lapatinib or capecitabine. The introduction of LC after the development of BMs may further improve survival compared with trastuzumab-based therapies only beyond brain progression.
Metro
G
G
Division of Medical Oncology, Regina Elena Cancer Institute, Rome.
Foglietta
J
J
Division of Medical Oncology, Ospedale S. Maria della Misericordia, Azienda Ospedaliera di Perugia.
Russillo
M
M
Division of Medical Oncology, Regina Elena Cancer Institute, Rome.
Stocchi
L
L
Division of Medical Oncology, Ospedale S. Maria della Misericordia, Azienda Ospedaliera di Perugia.
Vidiri
A
A
Diagnostic Imaging.
Giannarelli
D
D
Biostatistic Core.
Crinò
L
L
Division of Medical Oncology, Ospedale S. Maria della Misericordia, Azienda Ospedaliera di Perugia.
Papaldo
P
P
Division of Medical Oncology, Regina Elena Cancer Institute, Rome.
Mottolese
M
M
Department of Pathology, Regina Elena Cancer Institute, Rome, Italy.
Cognetti
F
F
Division of Medical Oncology, Regina Elena Cancer Institute, Rome.
Fabi
A
A
Division of Medical Oncology, Regina Elena Cancer Institute, Rome.
Gori
S
S
Division of Medical Oncology, Ospedale S. Maria della Misericordia, Azienda Ospedaliera di Perugia. Electronic address: stefania.gori@tin.it.
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology*; D000069287:Capecitabine; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D053208:Kaplan-Meier Estimate; D000077341:Lapatinib; D008875:Middle Aged; D011799:Quinazolines / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012189:Retrospective Studies; D000068878:Trastuzumab; D016896:Treatment Outcome; D055815:Young Adult
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000069287:Capecitabine; D003841:Deoxycytidine; D005472:Fluorouracil; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human