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View Full Version : until now, no way2 predict those benefiting Lapatinib+capecitabine(4her2+brainmets)


Lani
09-10-2013, 10:20 PM
Ann Oncol. 2013 Sep 6. [Epub ahead of print]

Circulating tumor cells and brain metastasis outcome in patients with HER2-positive breast cancer: the LANDSCAPE trial.

Pierga JY, Bidard FC, Cropet C, Tresca P, Dalenc F, Romieu G, Campone M, Mahier Aït-Oukhatar C, Le Rhun E, Gonçalves A, Leheurteur M, Dômont J, Gutierrez M, Curé H, Ferrero JM, Labbe-Devilliers C, Bachelot T.
Source
Department of Medical Oncology, Institut Curie and Université Paris Descartes, Paris.

Abstract
BACKGROUND:
Decrease of circulating tumor cells (CTC) during treatment is an independent prognostic factor in metastatic breast cancer (MBC). We specifically evaluated the impact of CTC on brain metastasis outcome.
METHODS:
HER2-positive MBC with brain metastasis not previously treated with whole-brain radiotherapy received first-line combination of lapatinib and capecitabine in a phase II study. CTC were detected at baseline and day 21 (CellSearch).
RESULTS:
Median follow-up of the 44 analyzed patients was 21.2 months. The central nervous system objective response (CNS-OR) rate was 66%. At baseline, 20 of 41 assessable patients for CTC (49%) had ≥1 CTC (range 1-301, median 3) and 9 (22%) had ≥5 CTC. At day 21, 7 of 38 patients (18%) had ≥1 CTC (P = 0.006, versus baseline), and CTC had disappeared in 11 patients. CNS-OR rate was significantly higher in patients with no CTC at day 21 [25 of 31 (80%) versus 2 of 7 (29%), P = 0.01]. The 1-year overall survival rate was 83.9% in patients with no CTC at day 21 versus 42.9% in patients with ≥1 CTC (P = 0.02).
CONCLUSIONS:
This is the first report showing a correlation between CNS metastasis response, outcome and early CTC clearance under targeted treatment of HER2+ MBC.
CLINICAL TRIALS NUMBER:
NCT00967031.
KEYWORDS:
HER2, brain metastasis, breast cancer, capecitabine, circulating tumor cells, lapatinib

PMID: 24013510 [PubMed - as supplied by publisher]