Abstract
BackgroundThe efficacy and safety of lapatinib plus capecitabine (LC or LX) versus trastuzumab plus chemotherapy in patients with HER-positive metastatic breast cancer who are resistant to trastuzumab is unknown.MethodsWe retrospectively analyzed data from breast cancer patients who began treatment with regimens of lapatinib plus capecitabine (LC or LX) or trastuzumab beyond progression (TBP) at eight hospitals between May 2010 and October 2017.ResultsAmong 554 patients who had developed resistance to trastuzumab, the median PFS (progression free survival) was 6.77 months in the LX group compared with 5.6 months in the TBP group (hazard ratio 0.804; 95% CI, 0.67 to 0.96; P = 0.019). The central nervous system progression rate during treatment was 5.9% in the LX group and 12.5% in the TBP group (P = 0.018).ConclusionThe combination of lapatinib and capecitabine showed a prolonged PFS relative to TBP in patients who had progressed on trastuzumab.
Highlights
The efficacy and safety of lapatinib plus capecitabine (LC or Lapatinib plus capecitabine (LX)) versus trastuzumab plus chemotherapy in patients with HER-positive metastatic breast cancer who are resistant to trastuzumab is unknown
Patients We retrospectively reviewed the medical records of Human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer patients at CSCO breast cancer database from May 2010 to October 2017
Efficacy The median PFS was 6.77 months in the LX group compared with 5.6 months in the trastuzumab beyond progression (TBP) group
Summary
The efficacy and safety of lapatinib plus capecitabine (LC or LX) versus trastuzumab plus chemotherapy in patients with HER-positive metastatic breast cancer who are resistant to trastuzumab is unknown. The introduction of the antiHER2 monoclonal antibody trastuzumab into clinical practice has dramatically improved the poor prognosis of this population of patient s[5,6,7]. Adding trastuzumab to the treatment regimen is the standard approach for treating HER-2 positive metastatic breast cancer. Despite its overall clinical efficacy, de novo and acquired resistance to trastuzumab administration have been observe d[9]. The development of distant metastases to liver, bone, lung and brain has become a major challenge in the management of patients with HER-2 positive breast cancer, probably due to their longer life expectancy and acquired trastuzumab resistanc e[10]. There is an urgent need to develop a new strategy for salvage therapy of patients who have developed resistance to trastuzumab
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