Clinical outcome of patients with brain metastases from HER2-positive breast cancer treated with lapatinib and capecitabine
Clinical outcome of patients with brain metastases from HER2-positive breast cancer treated with lapatinib and capecitabine
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DOI：
10.1093/annonc/mdq434
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发表时间：
2011-03-01
影响因子：
50.5
通讯作者：
Gori, S.
中科院分区：
文献类型：
--
作者：
Metro, G.;Foglietta, J.;Gori, S.
背景资料：在本研究中，我们调查了拉帕替尼和卡培他滨（LC）治疗的人表皮生长因子受体2阳性（HER 2+）乳腺癌（BC）脑转移（BM）患者的临床结局：81例HER 2+转移性BC患者在两个意大利机构接受LC治疗，确定了30例符合分析条件的BM。所有患者均接受曲妥珠单抗治疗转移性疾病。没有患者接受过拉帕替尼和/或卡培他滨。结果：中位年龄为45岁（范围24-75）和26 30例（86.7%）接受过颅前放疗。在22例BM可评价缓解的患者中，观察到7例部分缓解（31.8%）和6例疾病稳定（27.3%）。总体而言，中位脑特异性无进展生存期为5.6个月（95%置信区间4.4-6.8）。与23例仅在脑进展后接受曲妥珠单抗治疗的患者相比，接受LC治疗的患者的中位总生存期（从BM发生时间起）显著延长（分别为27.9个月和16.7个月，P = 0.01）。与仅在脑进展以外的基于曲妥珠单抗的治疗相比，在BM发生后引入LC可能会进一步改善生存率。
Background: In the present study, we investigated the clinical outcome of patients with brain metastases (BMs) from human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) treated with lapatinib and capecitabine (LC).Methods: Of 81 HER2+ metastatic BC patients treated with LC at two Italian institutions, 30 patients with BMs eligible for the analysis were identified. All patients were pretreated with trastuzumab for metastatic disease. No patients had received prior lapatinib and/or capecitabine.Results: Median age was 45 years (range 24-75) and 26 of 30 patients (86.7%) had received prior cranial radiotherapy. In the 22 patients with BMs evaluable for response, 7 partial responses (31.8%) and 6 disease stabilizations (27.3%) were observed. Overall, the median brain-specific progression-free survival was 5.6 months (95% confidence interval 4.4-6.8). Patients treated with LC had a median overall survival (from the time of development of BMs) significantly longer compared with 23 patients treated with trastuzumab-based therapies only beyond brain progression (27.9 months versus 16.7 months, respectively, P = 0.01).Conclusions: LC is active for BMs from HER2+ BC in patients not pretreated with either lapatinib or capecitabine. The introduction of LC after the development of BMs may further improve survival compared with trastuzumab-based therapies only beyond brain progression.