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

November 1, 2012

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."

Explore further: Drug boosts survival when breast cancer spreads to brain

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

Related Stories

Drug boosts survival when breast cancer spreads to brain

November 30, 2011
Treatment with lapatinib could extend survival in women with Her2-positive breast cancer that has spread to the brain, according to research published today in the British Journal of Cancer.

Trastuzumab and chemotherapy improved survival in HER2-postive breast and brain cancer patients

July 18, 2011
The use of trastuzumab, chemotherapy and surgery among women with HER2-positive metastatic breast cancer significantly improved survival from the time central nervous system metastases were diagnosed.

Breast cancer recurrence defined by hormone receptor status

October 1, 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 ...

Researchers seek to understand brain's immune response to metastasized cancer

September 25, 2012
Brain metastases are common secondary complications of other types of cancer, particularly lung, breast and skin cancer. The body's own immune response in the brain is rendered powerless in the fight against these metastases ...

Recommended for you

Clinical trial suggests new cell therapy for relapsed leukemia patients

November 20, 2017
A significant proportion of children and young adults with treatment-resistant B-cell leukemia who participated in a small study achieved remission with the help of a new form of gene therapy, according to researchers at ...

Researchers discover a new target for 'triple-negative' breast cancer

November 20, 2017
So-called "triple-negative" breast cancer is a particularly aggressive and difficult-to-treat form. It accounts for only about 10 percent of breast cancer cases, but is responsible for about 25 percent of breast cancer fatalities.

Study reveals new mechanism used by cancer cells to disarm attacking immune cells

November 20, 2017
A new study by researchers at The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (OSUCCC - James) identifies a substance released by pancreatic cancer cells that protects ...

Cell-weighing method could help doctors choose cancer drugs

November 20, 2017
Doctors have many drugs available to treat multiple myeloma, a type of blood cancer. However, there is no way to predict, by genetic markers or other means, how a patient will respond to a particular drug. This can lead to ...

Lung cancer triggers pulmonary hypertension

November 17, 2017
Shortness of breath and respiratory distress often increase the suffering of advanced-stage lung cancer patients. These symptoms can be triggered by pulmonary hypertension, as scientists at the Max Planck Institute for Heart ...

Researchers discover an Achilles heel in a lethal leukemia

November 16, 2017
Researchers have discovered how a linkage between two proteins in acute myeloid leukemia enables cancer cells to resist chemotherapy and showed that disrupting the linkage could render the cells vulnerable to treatment. St. ...

0 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.