Rapid tumor shrinkage with lapatinib plus capecitabine in a patient with massive liver involvement

Tumori. 2013 Nov-Dec;99(6):278e-81e. doi: 10.1700/1390.15468.

Abstract

We present the case of a 58-year-old woman with breast cancer metastasizing to the liver after adjuvant chemotherapy. A liver biopsy confirmed metastatic lesions from breast cancer that were immunohistochemically positive for estrogen/progesterone receptors and HER2. After first-line treatment with trastuzumab and vinorelbine, the patient commenced therapy with capecitabine (1000 mg/m2 twice daily, days 1-14) and lapatinib (1250 mg/day). Three months after the administration of this combination therapy, the liver metastases had shrunk substantially. Lapatinib may have the potential to convert trastuzumab-refractory tumors to trastuzumab-sensitive tumors in HER2-positive breast cancer by upregulation of the cell surface expression of HER2. Further study will be needed to evaluate in the clinic the combination of lapatinib and an m-TOR inhibitor as a treatment approach in HER2 overexpressing breast cancer that shows a poor response to trastuzumab.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / analysis*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Capecitabine
  • Chemotherapy, Adjuvant
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Drug Administration Schedule
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / analogs & derivatives
  • Humans
  • Immunohistochemistry
  • Lapatinib
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary*
  • Middle Aged
  • Quinazolines / administration & dosage
  • Receptor, ErbB-2 / analysis*
  • Receptors, Estrogen / analysis
  • Receptors, Progesterone / analysis
  • Tomography, X-Ray Computed
  • Trastuzumab
  • Treatment Outcome
  • Up-Regulation
  • Vinblastine / administration & dosage
  • Vinblastine / analogs & derivatives
  • Vinorelbine

Substances

  • Antibodies, Monoclonal, Humanized
  • Biomarkers, Tumor
  • Quinazolines
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Lapatinib
  • Deoxycytidine
  • Vinblastine
  • Capecitabine
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Vinorelbine
  • Fluorouracil