Drug combination shrinks secondary brain tumours in breast cancer without substantial side effects of radiotherapy

The sizeable and increasing proportion of women with advanced breast cancer whose disease has spread to the brain could be effectively treated systemically with a combination of two drugs, sparing them the debilitating neurological side effects of whole brain radiotherapy, suggests new research published Online First in The Lancet Oncology.

The phase 2 LANDSCAPE study reports that the combination of and capecitabine had similar response rates to WBRT, shrinking by at least 50% in two-thirds of women with advanced HER2-positive breast cancer, with a fifth of patients experiencing at least 80% reduction in tumour size, but with manageable side effects.

"As women live longer with advanced cancer the occurrence of is becoming increasingly common. Currently, 20% to 30% of women with develop secondary brain tumours. Those with HER2-positive disease seem to be most at risk, with up to half developing brain metastases", explains Thomas Bachelot from the Centre Léon Bérard in Lyon, France, who led the research. "Traditionally, most of these women receive WBRT which can impair cognitive function. Delaying such a treatment for those patients is potentially a big advance."

The study, conducted by the French cooperative group UNICANCER, assessed 45 patients all with previously untreated brain metastases from HER2-positive breast cancer, who were treated with a daily combination of lapatinib and capecitabine.

Overall, 37 patients (84%) experienced some reduction in brain tumour size from the start of the study. Tumours shrank by 50% or more in 29 women (66%) and by at least 80% in nine patients (20%).

Side effects with the combination therapy were predictable and manageable. About half of patients experienced at least one grade 3 or 4 side effect, the most common being diarrhoea and hand-foot syndrome, leading to treatment discontinuation in four women.

"Median time to WBRT was 8.3 months, which is particularly relevant for a population with short overall survival, and could help delay the substantial toxicities of radiotherapy", says Bachelot, adding that "This strategy deserves further evaluation to confirm the clinical benefits in terms of survival, cognitive function, and quality of life."

Writing in a linked Comment, Rupert Bartsch and Matthias Preusser from the Medical University of Vienna in Austria suggest that these findings might already be sufficient to begin treating some women in this fashion, sparing them from radiotherapy, "For patients with multiple brain metastases from HER2-positive presenting with minimal clinical symptoms and good performance status, primary systemic treatment containing lapatinib and capecitabine might already be a valid treatment option."

More information: www.thelancet.com/journals/lan… (12)70432-1/abstract

add to favorites email to friend print save as pdf

Related Stories

Drug combination shrinks breast cancer metastases in brain

Dec 16, 2007

A combination of a "targeted" therapy and chemotherapy shrank metastatic brain tumors by at least 50 percent in one-fifth of patients with aggressive HER2-positive breast cancer, according to data presented by Dana-Farber ...

Breast cancer recurrence defined by hormone receptor status

Oct 01, 2012

Human epidermal growth factor (HER2) positive breast cancers are often treated with the same therapy regardless of hormone receptor status. New research published in BioMed Central's open access journal Breast Cancer Research shows ...

Recommended for you

Mutations need help from aging tissue to cause leukemia

1 hour ago

Why are older people at higher risk for developing cancer? Prevailing opinion holds that, over time, your body's cells accumulate DNA damage and that eventually this damage catches up with the body in a way ...

Specific oxidation regulates cellular functions

6 hours ago

For a long time, hydrogen peroxide has been considered as a dangerous metabolite that can damage cells through oxidation. This, however, is not its only role in the cell. Scientists from the German Cancer Research Center ...

New disease mechanism discovered in lymphoma

7 hours ago

Programmed cell death is a mechanism that causes defective and potentially harmful cells to destroy themselves. It serves a number of purposes in the body, including the prevention of malignant tumor growth. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.