Any lapatinib experts out there?

[mts]

I have been reading the SABC abstracts and there was one specific topic that caught my eye. The subject was re: study of trastuzumab and lapatinib given together. Lapatinib does penetrate the blood-brain barrier. It stated the drugs were synergistic... Is anyone currently on this combination ??
We all recall how difficult it was for Stage I's to get Herceptin - if studies thus far indicate that Herceptin and lapatinib work well together, how long will it be before Stage I's can receive the same benefit of advanced drugs ?
This may sound stupid, but does one develop a resistance to lapatinib?

Maria

[Joe]

We have had info about this particular clinical trial posted on our clinical trials page for some time now. I believe the trial is being conducted by the Jonnson Comprehensive Cancer Care Center.


Regards
Joe

[Rupali]

This is something which has been on my mind also for a very long time. For early stagres what is the best way to get the combination of Lapatinib and Herceptin.

Joe, is the trial u mentioned recruiting early stage Her2+++ BC patients.

[Cathya]

If Lapatinib does penetrate the blood-brain barrier this would be a great treatment for brain mets I would think. If it can be taken with Herceptin I would like to try it. I have heard that borderline Her2 positives don't have the best results with Herceptin (please correct me if I am wrong....and I hope I am) so this would be a good, easy to take (available by pill) addition.

[StephN]

Hi gang -
I know we are all very interested in having a drug that will also protect our brain - ME included!

In San Antonio I had the good fortune (thanks to Eagle-eye Joe) to meet Dr. Eric Winer of Dana Farber in Boston who is heading up the Lapatinib trials. I told him about my bout with brain mets earlier this year and he did not seem to think I should just jump into trying to get this drug. He seemed to indicate that if I am otherwise NED and now have control of or resolved brain mets, that I should just stay with the Herceptin and close monitoring. He said he "hoped I would never need Lapatinib." This comment leads me to believe that it is still early stages and seemingly healthy patients are not going to get it for a while.

Phase three trials still use stage IV patients, so if you are early stage your chances of getting it any time soon are about nil. Recall how long it took to get Herceptin for adjuvent use.

The data on the success of this drug is still a long way from being compiled to the satisfaction of the FDA for wide spread use, according to the researchers.
Sorry to dash some hopes out there, but that is the picture from the "horses mouth."

P.S. - I am not an "expert" - just passing on what I learned last week. I think the expense of using it along with Herceptin in a "protective" manner would not fly with most insurance providers for seemingly healthy patients.

[AlaskaAngel]

When I brought up the BBB issue and lapatinib, the breast cancer onc who specializes in genetics that I saw last week also indicated that lapatinib still has too many significant problems.

A.A.

Hi, my name is Nicola...

I was diagnosed with DCIS in 2004 and was told that it was caught so early that they considered it stage "0", which I had never heard of before, didn't know there was such a thing as stage "0". I had surgery to remove the microcalcifications then had a second surgery to re-check the margins, pathology report came back that the margins were clean. I underwent radiation therapy and have been having mammograms every six months since then with nothing showing up in the breasts.

On Dec. 1, 2005 I started with terrible abdominal pain, after being fully examined and having an ultra-sound they determined that it was a gallbladder attack. I went in to have the gallbladder removed and when my surgeon went in he was shocked to find cancer spread throughout my liver in both lobes, he immediately did a liver biopsy and it came back HER2 positive. they also found cancer in my spine at the T8 & T9 vertebrae.

I am having a very difficult time understanding how stage "0" DCIS could have possibly metastasized. Apparently there was invasive breast cancer some where that was not caught.

The original plan was to attack the cancer through chemotherapy using the drugs Carboplatin, Taxol and Herceptin. I had a portacath put in on Dec. 16, 2005 and was scheduled to start chemo that very day but my onc called at the last minute with a change of plans and now wants to use Lapatinib, Taxol and Herceptin with Zometa given once a month. I am going in tomorrow to discuss Lapatinib which is still in clinical trial and to sign up for the trial. Hopefully this combination of drugs will be successful in putting me into remission. I am a little nervous about being on a clinical trial but willing to try anything. I was told that the only side effects of Lapatinib were rash and diarrhea and only occured in a small percentage of people. I am very anxious to get started on chemo but hate that I know very little about these drugs. I have done plenty of research and read about how wonderful Herceptin is but there isn't much info that I have found on Lapatinib.

If anyone is on this combination of chemo and can tell me anything about it I would greatly appreciate it. I am only 36 years old and lost my mother, aunt, and mother in-law to breast cancer so I know some of what to expect but things have advanced so much since then and I feel I am really behind on the latest treatment options. My sister directed me to this web site and I am so glad that she did. It is wonderful to be able to talk to other women who are going through this horrible ordeal.

Thanks so much for any help that anyone can give me.

Sincerely,
Nicola

[StephN]

Hi Nicola
Looks like you may be a trailblazer with this combination of drugs. A couple of the women who post here are taking Lapatinib, but mostly I think because the Herceptin is not working for them.
Your med onc is wise to give you this "cocktail" to try to shut down your advancing mets. The more ways you can get at the cancer cells, the better as they do multiply quite quickly.

Keep us posted on how you are feeling with all these drugs. There is also the Bayer serum HER2 test that will be able to tell if the drugs are working even before you can have new scans. Please search this site for the info on that test. Or talk to Joe and Christine about it. You are just the candidate for it!

[al from Canada]

Nicola,

I very sorry that this had to happen to you, this sounds absolutely terrible but it seems your onc is quite on-the-ball and I think what he is offerring you may be the future cadillac of treatments. Steph is right when dubbing you "trailblazer".
Stay in touch and maybe post on the "Newbie" board so your post doesn't get lost in the traffic. I think we can all learn from your up-comming ordeal. On the brighter side, many, many women on this site are SUCCESSFUL in their battle against liver mets sooo, hang in and stay in contact.

All the best,
Al

[Nicola]

Thank you so much for your kind words and for the info. This is such a wonderful site, I am so happy to be a part of it. I will definitely share with all of you any and all info I get and my progress.

Big Hugs,
Nicola