Journal of Neuro-Oncology

, Volume 105, Issue 3, pp 613–620 | Cite as

Randomized phase II study of lapatinib plus capecitabine or lapatinib plus topotecan for patients with HER2-positive breast cancer brain metastases

  • Nancy U. Lin
  • Wolfgang Eierman
  • Richard Greil
  • Mario Campone
  • Bella Kaufman
  • Klaudia Steplewski
  • Stephen R. Lane
  • Denise Zembryki
  • Stephen D. Rubin
  • Eric P. Winer
Clinical Study – Patient Study

Abstract

Approximately one-third of patients with advanced, HER2-positive breast cancer develop brain metastases. A significant proportion of women experience central nervous system (CNS) progression after standard radiation therapy. The optimal treatment in the refractory setting is undefined. This study evaluated the toxicity and efficacy of lapatinib in combination with chemotherapy among patients with HER2-positive, progressive brain metastases. Patients with HER2-positive breast cancer with progressive brain metastases after trastuzumab and cranial radiotherapy were included. The primary endpoint was CNS objective response, defined as a ≥50% volumetric reduction of CNS lesion(s) in the absence of new or progressive CNS or non-CNS lesions, or increasing steroid requirements. The study was closed early after 22 of a planned 110 patients were enrolled due to excess toxicity and lack of efficacy in the lapatinib plus topotecan arm. The objective response rate (ORR) in the lapatinib plus capecitabine arm was 38% (exact 95% confidence interval [CI] 13.9–68.4). No responses were observed in the lapatinib plus topotecan arm. Although the study was stopped prior to full enrollment, some promising indications of CNS activity were noted for lapatinib plus capecitabine. The combination of lapatinib plus topotecan was not active and was associated with excess toxicity.

Keywords

Lapatinib Capecitabine Topotecan Brain metastases Breast cancer 

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Nancy U. Lin
    • 1
  • Wolfgang Eierman
    • 2
  • Richard Greil
    • 3
  • Mario Campone
    • 4
  • Bella Kaufman
    • 5
  • Klaudia Steplewski
    • 6
  • Stephen R. Lane
    • 6
  • Denise Zembryki
    • 6
  • Stephen D. Rubin
    • 6
  • Eric P. Winer
    • 1
  1. 1.Division of Women’s Cancers, Department of Medical OncologyDana-Farber Cancer InstituteBostonUSA
  2. 2.Frauen Klinik Vom Roten KreuzMunichGermany
  3. 3.IIIrd Medical Department with Hematology and Medical OncologyPrivate Medical University HospitalSalzburgAustria
  4. 4.Centre Rene GauducheauSaint-HerblainFrance
  5. 5.Sheba Medical CenterTel HasomerIsrael
  6. 6.GlaxoSmithKlineCollegevilleUSA

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