A combination of a "targeted" therapy and chemotherapy shrank
metastatic brain tumors by at least 50 percent in one-fifth of patients
with aggressive HER2-positive breast cancer, according to data presented
by Dana-Farber Cancer Institute investigators at the San Antonio Breast
Lapatinib (Tykerb) and capecitabine (Xeloda) were paired in an
extension of a Phase 2 clinical trial in which lapatinib given alone
shrank brain metastases significantly in six percent of 241 patients.
In the extension trial, capecitabine was added to lapatinib in 49
patients whose metastases — cancerous colonies in the brain spread from
their primary cancer — had progressed while on treatment. With the
combination therapy, brain metastases shrank by 20 percent or more in 18
patients (37 percent) and shrank by at least 50 percent in 10 patients
(20 percent), reported Nancy Lin, MD, of Dana-Farber's Breast Oncology
"Very few medications have shown activity in the treatment of brain
metastases, particularly in HER-2-positive metastatic breast cancer
patients," said Lin, who led the study with Eric Winer, MD, director of
the Dana-Farber Breast Oncology Center. "Therefore, these data are quite
encouraging, and further studies are warranted."
Lapatinib is an oral small-molecule drug from GlaxoSmithKline that is
approved along with capecitabine for treating patients with advanced or
metastatic breast cancer whose tumors are driven by the abnormal growth
signal, HER-2, and who have already undergone therapy including
trastuzumab (Herceptin), a taxane drug, and an anthracycline compound.
Lapatinib, like trastuzumab, blocks the HER-2 signal.
Up to one-third of women with advanced, HER-2-positive breast cancer
may develop metastases to the brain. "Although radiation treatment is
often effective, as women live longer with metastatic cancer, some
develop worsening of brain metastases despite radiation," said Lin.
"Because cancer in the brain can have a major impact on quality of life,
it is important to have treatment options to address this problem."
The study was sponsored in part by GlaxoSmithKline.
Dana-Farber Cancer Institute (www.dana-farber.org)
is a principal teaching affiliate of the Harvard Medical School and is
among the leading cancer research and care centers in the United States.
It is a founding member of the Dana-Farber/Harvard Cancer Center
(DF/HCC), designated a comprehensive cancer center by the National