title: Objective response with lapatinib in patients with meningitis carcinomatosa derived from HER2/HER1-negative breast cancer.
abstract: A 45-year-old woman with HER2(-)/HER1(-) breast cancer underwent radical mastectomy, followed by radiation and chemotherapy. However, her symptoms progressed rapidly owing to meningitis carcinomatosa and she was fitted with a urethral catheter. She also had difficulty in walking. However, immediately after treatment with lapatinib, her symptoms almost completely disappeared. The catheter was removed and she no longer needed a wheelchair. Unfortunately, after treatment was stopped, the bilateral upper limb skin metastases reappeared, the brain metastases relapsed, and she again experienced symptoms of meningitis carcinomatosa. Lapatinib was restarted, resulting in an immediate improvement in the symptoms and a reduction in the skin and brain metastases. Immunohistochemical staining of the lapatinib-sensitive metastatic skin tumor showed it to be HER2(2+), FISH(-)/HER1(-). This result suggested that the lapatinib-sensitive lesions in the brain and meninges were also HER2-positive. Carcinomatosa meningitis has a very poor prognosis and no effective treatment has yet been developed. Here, we report the first case in which lapatinib has been used to effectively treat meningitis carcinomatosa in HER2(-)/HER1(-) relapsed breast cancer.
authors.affiliation: Department of Cancer Therapy and Research, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Hideya
authors.initials: H
authors.lastname: Onishi
authors.forename: Takashi
authors.initials: T
authors.lastname: Morisaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakafusa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yokohata
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Katano
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D006801:Humans; D000077341:Lapatinib; D008408:Mastectomy; D055756:Meningeal Carcinomatosis / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D011799:Quinazolines / Q000627:therapeutic use*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary
chemical_list: D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; C512478:EGFR protein, human; C508053:ERBB2 protein, human