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来那替尼在中华人民共和国治疗乳腺癌。

Lapatinib for the treatment of breast cancer in the People's Republic of China.

机构信息

Department of Breast Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.

出版信息

Onco Targets Ther. 2014 Jul 31;7:1367-73. doi: 10.2147/OTT.S60586. eCollection 2014.

Abstract

Lapatinib is an oral, small-molecule, reversible inhibitor of both epidermal growth factor receptor and human epidermal growth factor receptor-2 (HER2) tyrosine kinases. In March 2007, the US Food and Drug Administration approved lapatinib for use in combination with capecitabine for the treatment of women with HER2-overexpressing, advanced or metastatic breast cancer. This review discusses the available information of lapatinib in Chinese breast cancer patients, focusing on its effectiveness and clinical application against advanced or metastatic breast cancer. In pivotal phase III trials, a combination of lapatinib and capecitabine significantly decreased the risk of disease progression compared to capecitabine alone in women with HER2-positive advanced or metastatic breast cancer. Other trials were used to evaluate lapatinib in combination with hormone therapy, in combination with trastuzumab, and as an adjunct to adjuvant therapy for early-stage disease. Preclinical data have revealed that lapatinib is active in trastuzumab-resistant cell lines as well as synergistic with trastuzumab. In clinical trials, lapatinib has not been associated with serious or symptomatic cardiotoxicity. Further, it can cross the blood-brain barrier and may therefore have a role in preventing cancer progression in the central nervous system. Thus, lapatinib warrants further evaluation in HER2-positive metastatic and early-stage breast cancer patients.

摘要

拉帕替尼是一种口服的、小分子的、表皮生长因子受体和人表皮生长因子受体-2(HER2)酪氨酸激酶的可逆抑制剂。2007 年 3 月,美国食品和药物管理局批准拉帕替尼与卡培他滨联合用于治疗 HER2 过表达的晚期或转移性乳腺癌女性。本文综述了拉帕替尼在中国乳腺癌患者中的应用,重点介绍了其在治疗晚期或转移性乳腺癌方面的疗效和临床应用。在关键性的 III 期临床试验中,与卡培他滨单药治疗相比,拉帕替尼联合卡培他滨显著降低了 HER2 阳性晚期或转移性乳腺癌女性疾病进展的风险。其他试验用于评估拉帕替尼与激素治疗联合、与曲妥珠单抗联合以及作为辅助治疗早期疾病的辅助治疗。临床前数据显示,拉帕替尼在曲妥珠单抗耐药细胞系中具有活性,并且与曲妥珠单抗具有协同作用。在临床试验中,拉帕替尼并未导致严重或有症状的心脏毒性。此外,它可以穿过血脑屏障,因此可能在预防中枢神经系统癌症进展方面具有作用。因此,拉帕替尼值得进一步评估在 HER2 阳性转移性和早期乳腺癌患者中的应用。

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