Chemo, ‘targeted’ therapy combo shrinks metastatic brain tumours

Washington, Dec 17: According to a report, a combination of a ‘targeted’ therapy and chemotherapy reduces metastatic brain tumours by at least 50 percent in patients with aggressive HER2-positive breast cancer.

The study, led by Nancy Lin, MD, of Dana-Farber's Breast Oncology Centre and Eric Winer, MD, director of the Dana-Farber Breast Oncology Centre, found that combination of Lapatinib (Tykerb) and capecitabine (Xeloda) shrank brain metastases significantly in the patients.

Lapatinib is an oral small-molecule drug from GlaxoSmithKline that is approved along with capecitabine for treating patients with advanced or metastatic breast cancer whose tumours are driven by the abnormal growth signal, HER-2. Lapatinib blocks the HER-2 signal.

Lapatinib (Tykerb) and capecitabine (Xeloda) were paired in an extension of a Phase 2 clinical trial. In the Phase 2 clinical trial lapatinib was given alone, which shrank brain metastases significantly in six percent of 241 patients.

In the extension trial, capecitabine was added to lapatinib in 49 patients whose metastases, cancerous colonies in the brain spread from their primary cancer, had progressed while on treatment.

Nancy Lin, MD, of Dana-Farber's Breast Oncology Centre reported that with the combination therapy, brain metastases shrank by 20 percent or more in 18 patients and shrank by at least 50 percent in 10 patients.

"Very few medications have shown activity in the treatment of brain metastases, particularly in HER-2-positive metastatic breast cancer patients. Therefore, these data are quite encouraging, and further studies are warranted, " said Lin.

Up to one-third of women with advanced, HER-2-positive breast cancer may develop metastases to the brain.

"Although radiation treatment is often effective, as women live longer with metastatic cancer, some develop worsening of brain metastases despite radiation. Because cancer in the brain can have a major impact on quality of life, it is important to have treatment options to address this problem, " said Lin.

The data was presented at the San Antonio Breast Cancer Symposium.