BMC Cancer | |
Clinical outcomes of HER2-positive metastatic breast cancer patients with brain metastasis treated with lapatinib and capecitabine: an open-label expanded access study in Korea | |
Jungsil Ro5  Sohee Park5  Sung- Bae Kim7  Tae You Kim2  Young Hyuk Im4  Sun Young Rha1  Joo Seop Chung6  Hanlim Moon3  Sergio Santillana3  | |
[1] Department of Internal Medicine, Severance Hospital, Seodaemun-gu, South Korea | |
[2] Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea | |
[3] Department of Medical (AP Oncology). GlaxoSmithKline Oncology, Seoul, Republic of Korea | |
[4] Department of Hematology-Oncology, Samsung Medical Center, Seoul, Republic of Korea | |
[5] National Cancer Center Hospital and Research Institute, Goyang, Gyeonggi-do, 410-769, Republic of Korea | |
[6] Deparment of Medical Oncology, Pusan National University Hospital, Busan, Republic of Korea | |
[7] Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea | |
关键词: LEAP; Lapatinib and Capecitabine Therapy; HER2-positive Metastatic Breast Cancer; Brain Metastasis; | |
Others : 1080286 DOI : 10.1186/1471-2407-12-322 |
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received in 2012-03-08, accepted in 2012-06-26, 发布年份 2012 | |
【 摘 要 】
Background
To evaluate efficacy in patients with brain metastasis (BM) on entry into the lapatinib expanded access program (LEAP).
Methods
LEAP is a worldwide, single-arm, open-label study. HER2-positive, locally-advanced or metastatic breast cancer patients with progression after an anthracycline, taxane, and trastuzumab were eligible. Patients received capecitabine 2000 mg/m2 daily in two divided doses, days 1–14, every 21 days and lapatinib 1250 mg once daily.
Results
Among 186 patients enrolled in 6 Korean centers, 58 had BM. Progression-free survival (PFS) was 18.7 weeks in patients with BM and 19.4 weeks without BM (P = 0.88). In patients with BM, brain response was synchronized with systemic responses (P = 0.0001). Overall survival (OS) was 48.9 weeks in patients with BM and 64.6 weeks without BM (P = 0.23). Multivariable analysis found hormone receptor positivity (P = 0.003) and clinical benefit rate (CBR) of combined systemic and brain disease (P < 0.0001) significantly associated with prolonged brain PFS, and CBR of combined systemic and brain disease (P = 0.03) and longer trastuzumab use (P = 0.047) associated with prolonged OS in patients with BM; prior capecitabine did not affect PFS or OS in patients with BM.
Conclusion
Lapatinib plus capecitabine is equally effective in patients with or without BM.
Trial registration
ClinicalTrials.gov (NCT00338247)
【 授权许可】
2012 Ro et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20141202235446572.pdf | 430KB | download | |
Figure 2 . | 92KB | Image | download |
Figure 1 . | 51KB | Image | download |
【 图 表 】
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【 参考文献 】
- [1]Clayton AJ, Danson S, Jolly S, et al.: Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer. Br J Cancer 2004, 91:639-643.
- [2]Bendell JC, Domchek SM, Burstein HJ, et al.: Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer 2003, 97:2972-2977.
- [3]Ono M, Ando M, Yunokawa M, et al.: Brain metastases in patients who receive trastuzumab-containing chemotherapy for HER2-overexpressing metastatic breast cancer. Int J Clin Oncol 2009, 14:48-52.
- [4]Gori S, Rimondini S, De Angelis V, et al.: Central nervous system metastases in HER-2–positive metastatic breast cancer patients treated with trastuzumab: incidence, survival, and risk factors. Oncologist 2007, 12:766-773.
- [5]Geyer CE, Forster J, Lindquist D, et al.: Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 2006, 355:2733-2743.
- [6]Johnston S, Pippen JJ, Pivot X, et al.: Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor–positive metastatic breast cancer. J Clin Oncol 2009, 27:5538-5546.
- [7]Di Leo A, Gomez HL, Aziz Z, et al.: Phase III, double-blind, randomized study comparing lapatinib plus paclitaxel with placebo plus paclitaxel as first-line treatment for metastatic breast cancer. J Clin Oncol 2008, 26:5544-5552.
- [8]Cameron D, Casey M, Press M, et al.: A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses. Breast Cancer Res Treat 2008, 112:533-543.
- [9]Polli JW, Olson KL, Chism JP, et al.: An unexpected synergist role of P-glycoprotein and breast cancer resistance protein on the central nervous system penetration of the tyrosine kinase inhibitor lapatinib (N-{3-Chloro-4-[(3-fluorobenzyl)oxy]phenyl}-6-[5-({[2-(methylsulfonyl)ethyl]amino}methyl)-2-furyl]-4- quinazolinamine; GW572016). Drug Metab Dispos 2009, 37:439-442.
- [10]Gril G, Palmieri D, Bronder JL, et al.: Effect of lapatinib on the outgrowth of metastatic breast cancer cells to the brain. J Natl Cancer Inst 2008, 100:1092-1103.
- [11]Lin NU, Dieras V, Paul D, et al.: Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res 2009, 15:1452-1459.
- [12]Capri G, Chang J, Chen SC, et al.: An open-label expanded access study of lapatinib and capecitabine in patients with HER2-overexpressing locally advanced or metastatic breast cancer. Ann Oncol 2010, 21:474-480.
- [13]Boccardo F, Kaufman B, Baselga J, et al.: Evaluation of lapatinib plus capecitabine in patients with brain metastases from HER2+ breast cancer enrolled in the Lapatinib Expanded Access Program (LEAP) and French Authorisation Temporaire d’Utilisation (ATU). J Clin Oncol 2008, 26(suppl; abstr 1094: 64S): .
- [14]Campone M, El-Kouri C, Cottu P, et al.: French Lapatinib Authorization for Temporary Use (ATU): design, operation and initial safety data. Poster presented at 6th European Breast Cancer Conference; Berlin, Germany; April 15–19. , ; 2008.
- [15]Therasse P, Arbuck SG, Eisenhauer EA, et al.: New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 2000, 92:205-216.
- [16]Nam BH, Kim SY, Han HS, et al.: Breast cancer subtypes and survival in patients with brain metastases. Breast Cancer Res 2008, 10:R20. BioMed Central Full Text
- [17]Kennecke H, Yerushalmi R, Woods R, et al.: Metastatic behavior of breast cancer subtypes. J Clin Oncol 2010, 28:3271-3277.
- [18]Budman DR, Soong R, Calabro A, et al.: Identification of potentially useful combinations of epidermal growth factor receptor tyrosine kinase antagonists with conventional cytotoxic agents using median effect analysis. Anticancer Drugs 2006, 17:921-928.