According to results recently presented at the 2007 annual meeting of the American Society of Clinical Oncology, the targeted agent Tykerb® (lapatinib) may be effective in shrinking cancer that has spread to the brain among some patients with breast cancer.Tykerb is a targeted therapy that has produced promising results in women with metastatic or refractory breast cancer. Targeted therapies are anticancer drugs that are designed to treat cancer cells while reducing damage to normal, healthy cells. Tykerb targets two proteins that often function abnormally in breast cancer cells—HER2 and EGFR. When these proteins are increased in cancer cells (a condition referred to as HER2-positive and/or EGFR-positive cancers), the proteins tend to function abnormally, resulting in uncontrolled, faster growth of cancerous cells. Tykerb decreases or prevents the growth of these cancerous cells.Researchers recently reported results from a clinical study that suggested Tykerb may have anticancer activity among patients with brain metastasis from advanced HER2-positive breast cancer. This study included 241 patients whose brain metastasis continued to progress following therapy with Herceptin® (trastuzumab) and radiation therapy.Nearly half of the patients (46%) experienced at least a 20% reduction in the size of their brain metastasis.An additional 42% of patients achieved stabilization of their disease for at least eight weeks.Overall, 22% of patients had no signs of disease progression within the first six months of treatment with Tykerb.
The most common severe side effects were diarrhea, skin rash, nausea, vomiting, and fatigue.
The researchers concluded that among patients with advanced breast cancer: “Tykerb has promise in the treatment of brain metastases.” Further study of Tykerb in advanced breast cancer is ongoing at CORT. We are conducting a trial of Tykerb with either capecitabine (Xeloda) or topotecan (Hycamptin) chemotherapy for treatment of patients whose brain metastases continue to progress following treatment with Herceptin and radiation therapy.
Tykerb may also increase the activity of other therapies used for HER2-positive metastatic breast cancer patients. Currently, the combination of Herceptin and Taxol (paclitaxel) is a standard-of-care for initial therapy in these patients. CORT is conducting a study that compares that standard treatment of Herceptin and Taxol with or without the addition of Tykerb.
For more information about these studies, visit www.CORTPA.com or contact a Research Coordinator at 972-566-5588.
Tags: Breast Cancer, metastatic breast cancer, paclitaxel, Taxol, lapatinib, Tykerb, brain metastases, trastuzumab, Herceptin, capecitabine, Xeloda, topotecan, Hycamptin, targeted therapy, her-2 positive breast cancer
March 29, 2009 at 11:24 am |
I have a 34 year old Caucasian daughter with Inflammatory Breast Cancer and is also triple negative. She has completed 8 weeks of agressive treatment with adriamyacin and cytoxin. She will start taxol this Tuesday? Is there any research data that shows progress with Lapatinib and IBC and Triple Negative Breast Cancer? I have read the reports for IBC and positive receptors. She has been tested and does not have BRAC1 or BRCA2.
Thank you for any information regarding IBC and Triple Negative Breast Cancer.
Sincerely,
Jan Kasse
April 15, 2009 at 7:21 pm |
EGFR inhibitors, such as cetuximab (Erbitux, a monoclonal antibody against EGFR) have shown some promising activity in early studies in metatatic triple negative breast cancer (J Clin Oncol 26: 2008 (May 20 suppl; abstr 1009)). However, it might be some time before that activity is well established in metastatic disease treatment. As a general rule, studies to move such agents into adjuvant therapy situations generally will follow only if positive results are firmly established in patients with metastatic disease. That said, the use of EGFR inhibition in adjuvant therapy (treatment of non-metastatic cases) of triple ngative breast cancer is under study in ongoing trials. Erlotinib (Tarceva) is being combined with standard therapy in one study (http://clinicaltrials.gov/ct2/show/NCT00491816). Erlotinib is an oral EGFR inhibitor.
There is really no good rationale for Laptinib (Tykerb, an oral inhibitor of both EGFR=her-1 and her-2) in triple negative breast cancer, because the her-2 inhibiting component of the drug might increase the risk of cardiac dysfunction. Only the EGFR (her-1) blocking capacity of Lapatinib would be desirable.
BRCA mutations are found in a significant proportion of patients with triple negative breast cancer. So-called epigenetic changes (inactivation) of BRCA may exist in cases without mutations. Such changes may be induced by methylation of DNA regions that control gene transcription. Strategies to reverse such inactivation may soon be employed in clinical testing.