Dogan Izzet, Yıldız Anıl, Ahmed Melin Aydan, Vatansever Sezai
Department of Medical Oncology, Istanbul Faculty of Medicine, Istanbul University, Çapa/Fatih, 34093 Istanbul, Turkey.
Indian J Surg Oncol. 2024 Sep;15(3):489-494. doi: 10.1007/s13193-024-01936-8. Epub 2024 Apr 1.
Different targeted therapy options exist for treating HER2-positive metastatic breast cancer patients. This study evaluated the efficacy and tolerability of the lapatinib plus capecitabine combination after TDM-1 in HER2-positive metastatic breast cancer patients. We retrospectively evaluated the HER2-positive metastatic breast cancer patients' data. The patients who progressed after trastuzumab-based chemotherapy and TDM-1 were included in the study. We used the Kaplan-Meier for survival analysis. Eighteen patients were involved in the study. The average age was 48 (range 31-65). De novo metastatic patient's number was 5 (27.8%). The most common metastatic sites were liver (50%), lung (44.4%), and brain (44.4%), respectively. All patients were previously treated with trastuzumab + chemotherapy and TDM-1. Also, seven (38.9%) patients received hormonotherapy and twelve (66.7%) patients received palliative radiotherapy. The complete response ratio was 5.6%, partial response 11.8%, and stable response 29.4%. Median progression-free survival was found as 5.5 (95% CI, 3.2-7.7) months. The hematological and non-hematological toxicity ratio was 41.2% and 52.9%, respectively. Grade 3-4 toxicity (diarrhea, anemia, and mucositis) was observed in four (22.2%) patients. The median OS duration was 8.2 months (95% CI, 4.3-12.0). Treatment options are limited in heavily pretreated HER2-positive breast cancer patients. Despite a small number of patients, this study showed that the lapatinib plus capecitabine combination was effective and well-tolerated in heavily pretreated HER2-positive breast cancer patients after TDM-1.
治疗HER2阳性转移性乳腺癌患者有多种靶向治疗方案。本研究评估了拉帕替尼联合卡培他滨在HER2阳性转移性乳腺癌患者接受曲妥珠单抗 emtansine（TDM-1）治疗后的疗效和耐受性。我们回顾性评估了HER2阳性转移性乳腺癌患者的数据。纳入研究的患者为接受基于曲妥珠单抗的化疗和TDM-1治疗后病情进展的患者。我们使用Kaplan-Meier法进行生存分析。18例患者参与了研究。平均年龄为48岁（范围31 - 65岁）。初发转移性患者有5例（27.8%）。最常见的转移部位分别为肝脏（50%）、肺（44.4%）和脑（44.4%）。所有患者均曾接受曲妥珠单抗 + 化疗和TDM-1治疗。此外，7例（38.9%）患者接受了激素治疗，12例（66.7%）患者接受了姑息性放疗。完全缓解率为5.6%，部分缓解率为11.8%，病情稳定率为29.4%。中位无进展生存期为5.5个月（95%置信区间，3.2 - 7.7）。血液学和非血液学毒性发生率分别为41.2%和52.9%。4例（22.2%）患者出现3 - 4级毒性（腹泻、贫血和黏膜炎）。中位总生存期为8.2个月（95%置信区间，4.3 - 12.0）。对于预处理严重的HER2阳性乳腺癌患者，治疗选择有限。尽管患者数量较少，但本研究表明，拉帕替尼联合卡培他滨在HER2阳性乳腺癌患者接受TDM-1治疗后预处理严重的患者中有效且耐受性良好。
