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Combination Treatment Reduces Volume of Brain Metastases in Breast Cancer Patients: Presented at SABCS

By Ed Susman

SAN ANTONIO, TX -- December 17, 2007 -- The addition of capecitabine to lapatinib in patients with brain metastases from breast cancer was associated with additional responses in the central nervous system, researchers reported here at the 30th Annual San Antonio Breast Cancer Symposium (SABCS).

"Approximately one third of women with HER2-positive metastatic breast cancer develop central nervous system metastases," said Nancy Lin, MD, Instructor in Medicine, Dana-Farmer Cancer Institute, Boston, Massachusetts.

"Very few medications have shown activity in the treatment of brain metastases, in particular HER-positive metastatic breast cancer patients and, therefore, these data are quite encouraging," Dr. Lin said during her poster presentation on December 16.

The study enrolled 51 women who had been treated in a lapatinib monotherapy trial in which they received 750 mg of lapatinib twice a day. In the extension study, the women received 1,250 mg a day of lapatinib plus 2,000 mg/m² per day of capecitabine for 14 days in a 21-day cycle.

In the original study, 242 patients were enrolled and about 23% of patients achieved a 20% or greater decrease in brain tumor volume.

In the extension study, the median progression-free survival was 15.8 weeks. Dr. Lin said 10 of the women achieved a 50% reduction in the volume of their brain metastases and another 18 of the women experienced at least a 20% reduction in the volume of brain metastases.

"It is conceivable that the central nervous system responses observed in the extension arm were entirely as a result of capecitabine," Dr. Lin said, "However, it is equally possible that the activity is at least partially a consequence of coadministration-given synergy between HER2-directed therapy and chemotherapy."

Dr. Lin said that the study warrants prospective studies to evaluate the efficacy of lapatinib in combination with chemotherapy and other targeted agents for the treatment and prevention of central nervous system metastases in patients with HER2-positive metastatic breast cancer.

Funding for this study was provided by GlaxoSmithKline.


[Presentation title: Lapatinib and Capecitabine for the Treatment of Brain Metastases in Patients With HER2+ Breast Cancer an Updated Analysis From EGF105084. Abstract 6076]

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