Lapatinib plus capecitabine resolved human epidermal growth factor receptor 2-positive brain metastases

Stefan Glück, Aurelio Castrellon

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Brain metastases affect 25%-30% of women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer and are associated with a high burden of disease and poor prognosis. A 55-year-old woman presented with HER2-positive, hormone receptor-positive, locally advanced infiltrating ductal carcinoma. She received 4 cycles of neoadjuvant docetaxel (75 mg/m2) plus trastuzumab (6 mg/kg) on a 21-day cycle, resulting in complete pathologic response at the time of surgery. Trastuzumab (6 mg/kg every 21 days) plus anastrozole (1 mg/d) was continued for 1 year. Two years later, the patient progressed with pulmonary nodules and a large pleural effusion. Computed tomography and positron emission tomography revealed multiple lesions in the liver and thoracic spine but no evidence of brain metastases. The patient received weekly trastuzumab (2 mg/kg), paclitaxel (80 mg/m2), and carboplatin (area under the curve 2) for 6 months; her symptoms resolved and her disease stabilized. Seven months later, she developed diplopia and gait difficulties, and magnetic resonance imaging revealed multiple brain lesions. Whole-brain radiotherapy (30 Gy in 10 fractions) was delivered with excellent clinical results. The patient remained progression free without symptoms for approximately 3 months. When she developed central nervous system symptoms, she was treated with lapatinib (1250 mg/d continuously) plus capecitabine (2000 mg/m2 given on days 1-14 of a 21-day cycle). Four months later, a brain computed tomography performed shortly before her death from progressive systemic disease revealed near complete resolution of brain metastases. Lapatinib plus capecitabine seems to have clinical activity in HER2-positive brain metastases.

Original languageEnglish
Pages (from-to)585-590
Number of pages6
JournalAmerican Journal of Therapeutics
Volume16
Issue number6
DOIs
StatePublished - Nov 1 2009
Externally publishedYes

Fingerprint

Neoplasm Metastasis
Brain
docetaxel
Ductal Carcinoma
Diplopia
Carboplatin
Pleural Effusion
Paclitaxel
human ERBB2 protein
lapatinib
Capecitabine
Gait
Area Under Curve
Spine
Radiotherapy
Thorax
Central Nervous System
Tomography
Magnetic Resonance Imaging
Hormones

Keywords

  • Breast cancer
  • Central nervous system
  • Chemotherapy
  • Targeted therapy
  • Tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Lapatinib plus capecitabine resolved human epidermal growth factor receptor 2-positive brain metastases. / Glück, Stefan; Castrellon, Aurelio.

In: American Journal of Therapeutics, Vol. 16, No. 6, 01.11.2009, p. 585-590.

Research output: Contribution to journalArticle

@article{f7a2740adaf14ea1ad70c0685cf4f432,
title = "Lapatinib plus capecitabine resolved human epidermal growth factor receptor 2-positive brain metastases",
abstract = "Brain metastases affect 25{\%}-30{\%} of women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer and are associated with a high burden of disease and poor prognosis. A 55-year-old woman presented with HER2-positive, hormone receptor-positive, locally advanced infiltrating ductal carcinoma. She received 4 cycles of neoadjuvant docetaxel (75 mg/m2) plus trastuzumab (6 mg/kg) on a 21-day cycle, resulting in complete pathologic response at the time of surgery. Trastuzumab (6 mg/kg every 21 days) plus anastrozole (1 mg/d) was continued for 1 year. Two years later, the patient progressed with pulmonary nodules and a large pleural effusion. Computed tomography and positron emission tomography revealed multiple lesions in the liver and thoracic spine but no evidence of brain metastases. The patient received weekly trastuzumab (2 mg/kg), paclitaxel (80 mg/m2), and carboplatin (area under the curve 2) for 6 months; her symptoms resolved and her disease stabilized. Seven months later, she developed diplopia and gait difficulties, and magnetic resonance imaging revealed multiple brain lesions. Whole-brain radiotherapy (30 Gy in 10 fractions) was delivered with excellent clinical results. The patient remained progression free without symptoms for approximately 3 months. When she developed central nervous system symptoms, she was treated with lapatinib (1250 mg/d continuously) plus capecitabine (2000 mg/m2 given on days 1-14 of a 21-day cycle). Four months later, a brain computed tomography performed shortly before her death from progressive systemic disease revealed near complete resolution of brain metastases. Lapatinib plus capecitabine seems to have clinical activity in HER2-positive brain metastases.",
keywords = "Breast cancer, Central nervous system, Chemotherapy, Targeted therapy, Tyrosine kinase inhibitor",
author = "Stefan Gl{\"u}ck and Aurelio Castrellon",
year = "2009",
month = "11",
day = "1",
doi = "10.1097/MJT.0b013e31818bee2b",
language = "English",
volume = "16",
pages = "585--590",
journal = "American Journal of Therapeutics",
issn = "1075-2765",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Lapatinib plus capecitabine resolved human epidermal growth factor receptor 2-positive brain metastases

AU - Glück, Stefan

AU - Castrellon, Aurelio

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Brain metastases affect 25%-30% of women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer and are associated with a high burden of disease and poor prognosis. A 55-year-old woman presented with HER2-positive, hormone receptor-positive, locally advanced infiltrating ductal carcinoma. She received 4 cycles of neoadjuvant docetaxel (75 mg/m2) plus trastuzumab (6 mg/kg) on a 21-day cycle, resulting in complete pathologic response at the time of surgery. Trastuzumab (6 mg/kg every 21 days) plus anastrozole (1 mg/d) was continued for 1 year. Two years later, the patient progressed with pulmonary nodules and a large pleural effusion. Computed tomography and positron emission tomography revealed multiple lesions in the liver and thoracic spine but no evidence of brain metastases. The patient received weekly trastuzumab (2 mg/kg), paclitaxel (80 mg/m2), and carboplatin (area under the curve 2) for 6 months; her symptoms resolved and her disease stabilized. Seven months later, she developed diplopia and gait difficulties, and magnetic resonance imaging revealed multiple brain lesions. Whole-brain radiotherapy (30 Gy in 10 fractions) was delivered with excellent clinical results. The patient remained progression free without symptoms for approximately 3 months. When she developed central nervous system symptoms, she was treated with lapatinib (1250 mg/d continuously) plus capecitabine (2000 mg/m2 given on days 1-14 of a 21-day cycle). Four months later, a brain computed tomography performed shortly before her death from progressive systemic disease revealed near complete resolution of brain metastases. Lapatinib plus capecitabine seems to have clinical activity in HER2-positive brain metastases.

AB - Brain metastases affect 25%-30% of women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer and are associated with a high burden of disease and poor prognosis. A 55-year-old woman presented with HER2-positive, hormone receptor-positive, locally advanced infiltrating ductal carcinoma. She received 4 cycles of neoadjuvant docetaxel (75 mg/m2) plus trastuzumab (6 mg/kg) on a 21-day cycle, resulting in complete pathologic response at the time of surgery. Trastuzumab (6 mg/kg every 21 days) plus anastrozole (1 mg/d) was continued for 1 year. Two years later, the patient progressed with pulmonary nodules and a large pleural effusion. Computed tomography and positron emission tomography revealed multiple lesions in the liver and thoracic spine but no evidence of brain metastases. The patient received weekly trastuzumab (2 mg/kg), paclitaxel (80 mg/m2), and carboplatin (area under the curve 2) for 6 months; her symptoms resolved and her disease stabilized. Seven months later, she developed diplopia and gait difficulties, and magnetic resonance imaging revealed multiple brain lesions. Whole-brain radiotherapy (30 Gy in 10 fractions) was delivered with excellent clinical results. The patient remained progression free without symptoms for approximately 3 months. When she developed central nervous system symptoms, she was treated with lapatinib (1250 mg/d continuously) plus capecitabine (2000 mg/m2 given on days 1-14 of a 21-day cycle). Four months later, a brain computed tomography performed shortly before her death from progressive systemic disease revealed near complete resolution of brain metastases. Lapatinib plus capecitabine seems to have clinical activity in HER2-positive brain metastases.

KW - Breast cancer

KW - Central nervous system

KW - Chemotherapy

KW - Targeted therapy

KW - Tyrosine kinase inhibitor

UR - http://www.scopus.com/inward/record.url?scp=74549137869&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=74549137869&partnerID=8YFLogxK

U2 - 10.1097/MJT.0b013e31818bee2b

DO - 10.1097/MJT.0b013e31818bee2b

M3 - Article

C2 - 19287304

AN - SCOPUS:74549137869

VL - 16

SP - 585

EP - 590

JO - American Journal of Therapeutics

JF - American Journal of Therapeutics

SN - 1075-2765

IS - 6

ER -