Efficacy of lapatinib combined with capecitabine in patients with HER2‑positive metastatic breast cancer in a real‑world study

Gui,Xinyu; Li,Huiping; Yan,Ying; Zhang,Ruyan

doi:10.3892/ol.2020.12241

Efficacy of lapatinib combined with capecitabine in patients with HER2‑positive metastatic breast cancer in a real‑world study

Authors:
- Xinyu Gui
- Huiping Li
- Ying Yan
- Ruyan Zhang
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Affiliations: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, P.R. China
Published online on: October 22, 2020 https://doi.org/10.3892/ol.2020.12241
Article Number: 378
Copyright: © Gui et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to determine the efficacy and safety of lapatinib‑based treatment for patients with human epidermal growth factor receptor‑2‑positive (HER2⁺) metastatic breast cancer (MBC). The aim of the present real‑world study was to investigate the medical records and follow‑up information of 92 patients with HER2+ MBC who received a lapatinib‑based regimen at the recurrent/metastatic stage, 78 of whom had been pretreated with trastuzumab. The results demonstrated that the median progression‑free survival (PFS) was 5.8 months and the overall survival (OS) was 21.5 months, with an objective response rate (ORR) of 21.7%, disease control rate (DCR) of 87.0% and clinical benefit rate (CBR) of 47.8%. In the patients receiving a lapatinib‑based regimen as first‑, second‑ and third/later‑line treatment, the median PFS was 10.4, 5.2 and 5.1 months (P=0.048), the median OS was 32.9, 29.1 and 13.0 months (P<0.001), the ORR was 38.9, 23.3 and 13.60%, and the DCR was 100, 83.3 and 84.1%, respectively. In the trastuzumab‑resistant (n=71) and trastuzumab‑sensitive (n=21) patients, the median PFS was 5.2 and 9.1 months (P=0.032), and the median OS was 21.4 and 44.3 months (P=0.003), respectively. In the patients who received lapatinib plus chemotherapy (n=68), the median PFS with lapatinib plus capecitabine (n=38) was 8.1 months, as compared with the 5.1 months with lapatinib plus other chemotherapy agents (n=30; P=0.005). The median PFS of 14 patients with brain metastases was 8.4 months, with an ORR of 35.7% and a DCR of 85.7%. Multivariate analysis revealed that the line of lapatinib‑based treatment and its combination with capecitabine or a different agent were independent prognostic factors for the median PFS in patients with HER2⁺ MBC. A limited number of adverse events were observed with the combination of lapatinib and capecitabine. Therefore, the findings of the present study suggested that lapatinib‑based treatment is effective in patients with HER2⁺ MBC (even in trastuzumab‑pretreated patients), and the combination of lapatinib with capecitabine may be recommended due to its good efficacy, convenience and tolerability.

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