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Clinical outcomes in patients who received lapatinib plus capecitabine combination therapy for HER2-positive breast cancer with brain metastasis and a comparison of survival with those who received trastuzumab-based therapy: a study by the Anatolian Society of Medical Oncology |
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| Authors: | Muhammet Ali Kaplan Abdurrahman Isikdogan Doğan Koca Mehmet Kucukoner Ozge Gumusay Ramazan Yildiz Adem Dayan Lütfiye Demir Caglayan Geredeli Murat Kocer Ulku Yalcintas Arslan Ali İnal Tulay Akman Ugur Coskun Nur Sener Mevlude Inanc Emin Tamer Elkiran Nuriye Yildirim Ozdemir Ayse Gok Durnalı Ali Suner Suleyman Alici Mustafa Oktay Tarhan Cem Boruban Berna Oksuzoglu Zuhat Urakci |
| Affiliation: | 1. Department of Medical Oncology, Dicle University School of Medicine, 21280, Diyarbakir, Turkey 2. Department of Medical Oncology, Dokuz Eylul University School of Medicine, Izmir, Turkey 3. Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey 4. Department of Medical Oncology, Dr. Lutfi K?rdar Kartal Training and Research Hospital, Istanbul, Turkey 7. Department of Medical Oncology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey 8. Department of Medical Oncology, Selcuk University School of Medicine, Konya, Turkey 9. Department of Medical Oncology, Suleyman Demirel University School of Medicine, Isparta, Turkey 5. Department of Medical Oncology, Ankara Oncology Training and Research Hospital-2, Ankara, Turkey 10. Department of Medical Oncology, Erciyes University School of Medicine, Kayseri, Turkey 14. Department of Medical Oncology, Inonu University School of Medicine, Malatya, Turkey 13. Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey 6. Department of Medical Oncology, Ankara Oncology Training and Research Hospital-1, Ankara, Turkey 11. Department of Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey 12. Department of Medical Oncology, G?ztepe Medical Park Hospital, Ankara, Turkey |
| Abstract: | PurposeIn this study, we investigated the effect of lapatinib plus capecitabine treatment in HER2-positive breast cancer patients with brain metastasis.MethodsOf 405 metastatic breast cancer patients with brain metastases at referral centers in Turkey, 46 were treated with lapatinib plus capecitabine only after the development of brain metastasis. Patients who only received trastuzumab-based therapy after the development of brain metastases were accepted as the historic control group for survival analyses (n = 65). Patients who received both drugs consecutively or sequentially were excluded from the analyses (n = 34).ResultsMedian age among 46 patients who received lapatinib plus capecitabine therapy was 45 years (27–76), and median time for development of brain metastases was 11.9 months (0–69 months). Twenty-six out of 38 patients who received lapatinib plus capecitabine and had extracranial metastasis showed partial response or stable diseases (68.4 %). Grade 3-4 toxicity was observed in eight patients (17.3 %). Median overall survival (OS) in patients treated with lapatinib plus capecitabine was significantly increased compared to that in patients treated with trastuzumab-based therapy (19.1 vs. 12 months, respectively, p = 0.039). The incidence of cerebral death was slightly decreased in patients who received lapatinib plus capecitabine compared to those who received trastuzumab-based therapy (32 vs. 43.4 %, p = 0.332). In the multivariate analysis, lapatinib plus capecitabine therapy remained an independent positive predictor for survival [odds ratio (OR), 0.57; p = 0.02].DiscussionAlthough this retrospective multicenter study had several limitations, the results suggest that undergoing lapatinib plus capecitabine therapy after the diagnosis of brain metastasis may further improve survival compared to undergoing only trastuzumab-based therapy. |
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