Kaplan Muhammet Ali, Isikdogan Abdurrahman, Koca Doğan, Kucukoner Mehmet, Gumusay Ozge, Yildiz Ramazan, Dayan Adem, Demir Lütfiye, Geredeli Caglayan, Kocer Murat, Arslan Ulku Yalcintas, Inal Ali, Akman Tulay, Coskun Ugur, Sener Nur, Inanc Mevlude, Elkiran Emin Tamer, Ozdemir Nuriye Yildirim, Durnalı Ayse Gok, Suner Ali, Alici Suleyman, Tarhan Mustafa Oktay, Boruban Cem, Oksuzoglu Berna, Urakci Zuhat
Department of Medical Oncology, Dicle University School of Medicine, 21280, Diyarbakir, Turkey,
Breast Cancer. 2014 Nov;21(6):677-83. doi: 10.1007/s12282-013-0441-y. Epub 2013 Jan 19.
In this study, we investigated the effect of lapatinib plus capecitabine treatment in HER2-positive breast cancer patients with brain metastasis.
Of 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).
Median 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].
Although 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.
在本研究中，我们调查了拉帕替尼联合卡培他滨治疗HER2阳性脑转移乳腺癌患者的效果。
在土耳其转诊中心的405例伴有脑转移的转移性乳腺癌患者中，46例仅在出现脑转移后接受拉帕替尼联合卡培他滨治疗。脑转移出现后仅接受基于曲妥珠单抗治疗的患者被作为生存分析的历史对照组（n = 65）。连续或序贯接受两种药物治疗的患者被排除在分析之外（n = 34）。
接受拉帕替尼联合卡培他滨治疗的46例患者的中位年龄为45岁（27 - 76岁），出现脑转移的中位时间为11.9个月（0 - 69个月）。接受拉帕替尼联合卡培他滨且有颅外转移的38例患者中，26例显示部分缓解或病情稳定（68.4%）。8例患者（17.3%）观察到3 - 4级毒性。与接受基于曲妥珠单抗治疗的患者相比，接受拉帕替尼联合卡培他滨治疗的患者的中位总生存期（OS）显著延长（分别为19.1个月和12个月，p = 0.039）。与接受基于曲妥珠单抗治疗的患者相比，接受拉帕替尼联合卡培他滨治疗的患者脑死亡发生率略有下降（32%对43.
