The role of insulin-like growth factor-I receptor in the development of Herceptin resistance

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Adjuvan tedavisonrasi veya tanıda izole beyin metastazı olan hastların klinkopatolojik karekteristikleri ve sağ kalımlarının değerlendirilmesi

SSS metastazı meme kanserinin geç dönemlerinde ortaya çıkar. Klasik yaklaşım, semptomatik olunca tedavi etmektir. Adjuvan tedavi sonrası veya başlangıçta tanıda, yalnızca beyin metastazı olan hastaların, klinikopatolojik karekteristiklerini inceledik ve sağkalımı değerlendiridik. Yazarlar, retrospektif olarak iki üniversite hastanesinden 3600 meme kanserli hastayı değerlendirip, içlerinden sadece ve tek olarak beyin metastazlı olan 31 hastayı çalışmaya aldılar. ER, PR, cerbB2 durumu, T , N evresi , grad, adju van taksan, trastuzumab, hormonal tedaviler, trastuzumab ve palatinin beyin metastazından sonra kullanımı sağ kalımı etkileme di. Cerrahi ve tüm beyin ışınlaması cerbB2 negatif hastlarda, tüm beyin ışınlaması ise cerB2 pozitif hastlarda daha etkili olabilir. (p0.06). Sağ kalım pre ve perimenapozallerde daha iyi olabilir. mOS pre ve perimenapozallerde 17.7 ay postmenapozallerde 10.3 ay bulundu. (p0.06) Lapatinib izole beyin metastazlı hastlarda mOSı etkileyebilir. Bazı prognostic faktörler, hangi tadaviden, hangi hasta gurubunun faydalanacağını öngörmemizi sağlayabilir. Daha çok hasta içeren çalışmalara olan ihtiyaç açıktır.CNS metastases usually appears late in the progression of metastatic breast cancer. Classical approach is evaluating and treat­ing them when symptoms become evident. We evaluated the survival and described clinicopathologic characteristics of patients in whom the brain metastases after adjuvant treatment or at initial diagnosis are the first and the only side. Authors retrospec­ tively evaluated about 3600 patients with breast cancer treated in two university hospitals. In those 31 patients with first and only metastases to brain and no other metastases were evaluated. ER, PR, cerbB2 status T, N stage, grade, adjuvant taxane, trastuzumab, hormonal treatment, trastuzumab and platine use after brain metastases didnt effect the survival. Surgery and WBRT may be more effective in cerbB2 negative patients, WBRT in cerbB2 positive ones. (p0.06). The survival outcome may be better in pre and perimenouposal women. The mOS of pre and perimenopausal, postmenopausal women were 17.7 months and 10.3 months respectively (p0.06) and lapatinib may affect the mOS of patients with isolated brain metastases. Some prognostic factor may help us to foresee which group may benefit more from which treatment modality. The need for studies with larger groups of patients is obvious

Lapatinib plus capecitabine for HER2-positive advanced breast cancer: a multicentre study of Anatolian Society of Medical Oncology (ASMO)

Lapatinib is the first dual tyrosine kinase inhibitor of human epidermal growth factor receptor type 2 (HER2/neu) and epidermal growth factor receptor (EGFR). The present study evaluated the efficacy and tolerability of the combination of lapatinib and capecitabine in patients with metastatic breast cancer (MBC) who progressed after therapy with trastuzumab, a taxane and/or anthracycline. A total of 203 patients with a median age of 48 years (range: 25-82 years) were evaluated retrospectively in 11 centres between September 2007 and May 2011. All the patients had HER2-positive MBC progressing after trastuzumab and chemotherapy including an anthracycline and/or taxane. All patients were treated with the combination of lapatinib (1250 mg/day, continuously) and capecitabine (2000 mg/m(2) on days 1 through 14 of a 21-day cycle). Data on demographics, clinical outcome, and toxicity were collected for descriptive analyses. The median follow-up was 10.7 months (range: 1-40 months). An overall response rate (ORR) of 33.4% was achieved including 7 complete responses (CR, 3.4%), 61 partial responses (PR, 30.0%), and 44 stable disease (37.9%). Clinical benefit rate of 71.3% was achieved. Median progression-free survival (PFS) was 7 months (95% CI: 6-10 months), with a median overall survival (OS) of 15 months (95% CI: 12-18 months). The most common side effects were hand-foot syndrome (46.8%), nausea (42.3%), fatigue (42.2%), anorexia (38.5%), diarrhea (31.5%), and rash (29.6%). Grade 3-4 toxicities were identified as hand foot syndrome (7.9%), diarrhea (6.9%), fatigue (5.9%), and rash (5.4%). There were no symptomatic cardiac events. Lapatinib and capecitabine combination therapy is effective and well tolerated in patients with MBC who had progressive disease after trastuzumab, taxane, and/or anthracycline therapy, as evidenced by this retrospective evaluation. Toxicity was mild to moderate with low grade 3-4 toxicity

Lapatinib plus Capecitabine for Brain Metastases in Patients with Human Epidermal Growth Factor Receptor 2-Positive Advanced Breast Cancer: A Review of the Anatolian Society of Medical Oncology (ASMO) Experience

Background: We investigated the clinical outcome of patients with brain metastases (BMs) from human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (MBC) treated with lapatinib and capecitabine (LC). Patients and Methods: A total of 203 patients with HER2+ MBC, who had progressed after trastuzumab-containing chemotherapy, were retrospectively evaluated in 11 centers between September 2009 and May 2011. 85 patients who had developed BMs before the initiation of treatment with LC were included. All patients had received prior cranial radiotherapy. All patients were treated with the combination of lapatinib (1,250 mg/day continuously) and capecitabine (2,000 mg/m(2) on days 1-14 of a 21-day cycle). Results: The median follow-up was 10.5 months (range 1-38 months). An overall response rate of 27.1% was achieved, including complete response in 2 (2.4%) and partial response in 21 (24.7%) patients. Median progression-free survival was 7 months (95% confidence interval (CI) 5-9), with a median overall survival of 13 months (95% Cl 9-17). The most common side effects were hand-foot syndrome (58.8%), nausea (55.3%), fatigue (48.9%), anorexia (45.9%), rash (36.5%), and diarrhea (35.4%). Grade 3-4 toxicities were hand-foot syndrome (9.4%), diarrhea (8.3%), fatigue (5.9%), and rash (4.7%). There were no symptomatic cardiac events. Conclusion: LC combination therapy was effective and well-tolerated in patients with HER2+ MBC with BMs, who had progressive disease after trastuzumab-containing therapy.BACKGROUND: We investigated the clinical outcome of patients with brainmetastases (BMs) from human epidermal growth factor receptor 2-positive (HER2+)metastatic breast cancer (MBC) treated with lapatinib and capecitabine (LC).PATIENTS AND METHODS: A total of 203 patients with HER2+ MBC, who had progressed after trastuzumab-containing chemotherapy, were retrospectively evaluated in 11centers between September 2009 and May 2011. 85 patients who had developed BMsbefore the initiation of treatment with LC were included. All patients hadreceived prior cranial radiotherapy. All patients were treated with thecombination of lapatinib (1,250 mg/day continuously) and capecitabine (2,000mg/m(2) on days 1-14 of a 21-day cycle).RESULTS: The median follow-up was 10.5 months (range 1-38 months). An overallresponse rate of 27.1% was achieved, including complete response in 2 (2.4%) and partial response in 21 (24.7%) patients. Median progression-free survival was 7months (95% confidence interval (CI) 5-9), with a median overall survival of 13months (95% Cl 9-17). The most common side effects were hand-foot syndrome(58.8%), nausea (55.3%), fatigue (48.9%), anorexia (45.9%), rash (36.5%), anddiarrhea (35.4%). Grade 3-4 toxicities were hand-foot syndrome (9.4%), diarrhea(8.3%), fatigue (5.9%), and rash (4.7%). There were no symptomatic cardiacevents.CONCLUSION: LC combination therapy was effective and well-tolerated in patientswith HER2+ MBC with BMs, who had progressive disease after trastuzumab-containingtherapy