Herceptin/Capecitabine combination effective in heavily pretreated Stage IV her2+ bc

[Lani]

Capecitabine-Trastuzumab Safe, Effective in Pretreated Metastatic Breast Cancer

NEW YORK (Reuters Health) Sept 21 - The combination of capecitabine plus trastuzumab is safe and effective for women with heavily pretreated metastatic breast cancer, according to a report in the September 1st issue of the Journal of Clinical Oncology.

"Patients with HER2-positive breast cancer need treatment over a long period of time," Dr. Guenther G. Steger from the Medical University of Vienna, Austria told Reuters Health. "Thus, it is essential that many different treatment options are available since none of them is curative for the time being. Our data show that capecitabine plus trastuzumab is an effective and feasible option for these patients, which can be considered any time during the treatment course."

Dr. Steger and colleagues investigated the capecitabine and trastuzumab combination as salvage therapy in 40 heavily pretreated women with metastatic breast cancer after earlier trastuzumab exposure.

One patient experienced a complete response, 7 had partial responses, and 20 had stable disease lasting at least 6 months, the authors report, for an overall response rate of 20% and a clinical benefit rate of 70%.

The combination was well tolerated, and there were no treatment-related deaths. Twenty-two women required a delay of cycles because of adverse effects, mainly hand-foot syndrome or diarrhea, the investigators say.

Median time to progression was 8 months, and median overall survival was 24 months, the researchers note.

"A prospective, randomized trial of capecitabine plus trastuzumab vs. capecitabine plus lapatinib in patients after first trastuzumab failure (i.e., capecitabine with relapse after adjuvant or first-line palliative trastuzumab), with the primary endpoint time-to-progression, appears to be warranted," Dr. Steger said. "Also capecitabine plus trastuzumab with or without lapatinib in this setting would be attractive."

J Clin Oncol 2007;25:3853-3858.