[A case of effective lapatinib/capecitabine therapy for HER2-positive breast cancer with multiple brain metastases]

Gan To Kagaku Ryoho. 2012 Nov;39(11):1699-702.
[Article in Japanese]

Abstract

A 63-year-old woman was suffering from HER2-positive and hormone receptor-negative breast cancer with bone metastasis. She received 16 cycles of paclitaxel(PTX 80mg/m2)plus trastuzumab(TRA 2mg/kg)on a 7-day cycle, and zoledronic acid(ZOL 4mg/body every 28 days), resulting in a near clinical complete response(cCR). Two years later, the patient complained of dizziness and nausea, and magnetic resonance imaging revealed multiple brain metastases. The prior treatments with PTX and TRA were changed to lapatinib(LAP)(orally at 1, 250mg/day every day)and capecitabine(CAP)(orally at 2, 000mg/m2 every day for 2 weeks, followed by a 1-week rest interval as 1 cycle)because of the multiple brain metastases. After 4 cycles of treatment, the number of brain lesions and the tumor sizes were significantly reduced. After 7 cycles, however, magnetic resonance imaging revealed the deterioration of some brain lesions. After whole-brain irradiation(30 Gy in 10 fractions)was added to the treatment, the outcome was near cCR. In conclusion, combination therapy of Lap and Cap may be an effective treatment option for brain metastasis of HER2-positive breast cancer.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Neoplasms / chemistry
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary
  • Brain Neoplasms / therapy
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Capecitabine
  • Chemoradiotherapy
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / analogs & derivatives
  • Humans
  • Lapatinib
  • Middle Aged
  • Quinazolines / administration & dosage
  • Receptor, ErbB-2 / analysis*
  • Remission Induction

Substances

  • Quinazolines
  • Lapatinib
  • Deoxycytidine
  • Capecitabine
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Fluorouracil