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Home > Understanding Breast Cancer > Breast Cancer Research > Table 51: Lapatinib and treatment for metastatic breast cancer

  


Table 51: Lapatinib and treatment for metastatic breast cancer

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: The drug lapatinib (Tykerb) is a tyrosine-kinase inhibitor. This class of drugs targets enzymes important for cell functions (called tyrosine-kinase enzymes). Lapatinib is used to treat HER2/neu-positive metastatic breast cancer in women who have already had chemotherapy and trastuzumab (Herceptin).  

Lapatinib combined with chemotherapy, hormone therapy or trastuzumab may increase progression-free survival (the length of time before the metastatic breast cancer spreads).

Side effects of lapatinib

Side effects of lapatinib include diarrhea, nausea, vomiting, rash and fatigue. In rare cases, it has been linked to lung problems [1].  

Learn more about lapatinib.

Study selection criteria: Phase III clinical trials with 100 or more participants with HER2/neu-positive metastatic breast cancer. For phase III clinical trials of chemotherapy, all participants had past treatment with chemotherapy and trastuzumab for metastatic breast cancer. For phase III clinical trials of hormone therapy, past treatment varied.  

Study 

Study Population
(number of participants)
 

Drug(s) Used 

Overall Response Rate—Percent who Responded to Treatment
(95% CI)
 

Overall Survival 
at One Year
 

Phase III Clinical Trials-Chemotherapy 

Guan et al. [2]

444

Lapatinib with chemotherapy
(paclitaxel)

 69%
(63-75%)

69%*

   

 Chemotherapy alone
(paclitaxel)

 50%
(43-56%)

63%*

Geyer et al. [3]

324

Lapatinib with chemotherapy
(capecitabine)  

22%
(16-29%) 

14%

 

 

Chemotherapy alone
(capecitabine)

14%
(9-21%)

14%

Phase III Clinical Trials-Hormone Therapy  

Schwartzberg et al. [4] 

219
women with no prior treatment
for metastatic breast cancer  

Lapatinib with letrozole 

28%†

 
   

Letrozole alone

15%†  

Johnston et al. [5]

219

Lapatinib with letrozole 

33%

72%*

   

 Letrozole alone

32%

64%*

 Phase III Clinical Trials-Trastuzumab  

Blackwell et al. [6-7]

291

Lapatinib with trastuzumab

10%

56%

   

Lapatinib alone

7%

41%

* Estimated overall survival at 15 months.

† Statistically significant difference between the two treatment groups.  
 

References  

  1. Amir E, Ocaña A, Seruga B, Freedman O, Clemons M. Lapatinib and HER2 status: results of a meta-analysis of randomized phase III trials in metastatic breast cancer. Cancer Treat Rev. 36(5):410-5, 2010.
  2. Guan Z, Xu B, DeSilvio ML, et al. Randomized trial of lapatinib versus placebo added to paclitaxel in the treatment of human epidermal growth factor receptor 2-overexpressing metastatic breast cancer. J Clin Oncol. 31(16):1947-53, 2013. 
  3. Geyer CE, Forster J, Lindquist D, et al. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med. 355(26):2733-43, 2006.
  4. Schwartzberg LS, Franco SX, Florance A, O'Rourke L, Maltzman J, Johnston S. Lapatinib plus letrozole as first-line therapy for HER-2+ hormone receptor-positive metastatic breast cancer. Oncologist. 15(2):122-9, 2010.
  5. Johnston S, Pippen J Jr, Pivot X, et al. Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor-positive metastatic breast cancer. J Clin Oncol. 27(33):5538-46, 2009.
  6. Blackwell KL, Burstein HJ, Storniolo AM, et al. Randomized study of lapatinib alone or in combination with trastuzumab in women with ErbB2-positive, trastuzumab-refractory metastatic breast cancer. J Clin Oncol. 28(7):1124-30, 2010.
  7. Blackwell KL, Burstein HJ, Storniolo AM, et al. Overall survival benefit with lapatinib in combination with trastuzumab for patients with human epidermal growth factor receptor 2-positive metastatic breast cancer: final results from the EGF104900 Study. J Clin Oncol. 30(21):2585-92, 2012.

Updated 01/13/14