title: [A case of effective lapatinib/capecitabine therapy for HER2-positive breast cancer with multiple brain metastases].
abstract: A 63-year-old woman was suffering from HER2-positive and hormone receptor-negative breast cancer with bone metastasis. She received 16 cycles of paclitaxel(PTX 80mg/m2)plus trastuzumab(TRA 2mg/kg)on a 7-day cycle, and zoledronic acid(ZOL 4mg/body every 28 days), resulting in a near clinical complete response(cCR). Two years later, the patient complained of dizziness and nausea, and magnetic resonance imaging revealed multiple brain metastases. The prior treatments with PTX and TRA were changed to lapatinib(LAP)(orally at 1, 250mg/day every day)and capecitabine(CAP)(orally at 2, 000mg/m2 every day for 2 weeks, followed by a 1-week rest interval as 1 cycle)because of the multiple brain metastases. After 4 cycles of treatment, the number of brain lesions and the tumor sizes were significantly reduced. After 7 cycles, however, magnetic resonance imaging revealed the deterioration of some brain lesions. After whole-brain irradiation(30 Gy in 10 fractions)was added to the treatment, the outcome was near cCR. In conclusion, combination therapy of Lap and Cap may be an effective treatment option for brain metastasis of HER2-positive breast cancer.
authors.affiliation: Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fujita
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Mizuta
authors.forename: Koichi
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakatsukasa
authors.forename: Aya
authors.initials: A
authors.lastname: Imai
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Umeda
authors.forename: Asako
authors.initials: A
authors.lastname: Hamaoka
authors.forename: Midori
authors.initials: M
authors.lastname: Morita
authors.forename: Mari
authors.initials: M
authors.lastname: Shouji
authors.forename: Mariko
authors.initials: M
authors.lastname: Goto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000556:secondary / Q000628:therapy; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D000069287:Capecitabine; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D000077341:Lapatinib; D008875:Middle Aged; D011799:Quinazolines / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D012074:Remission Induction
chemical_list: D000069287:Capecitabine; D003841:Deoxycytidine; D005472:Fluorouracil; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human