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Case Report
Lapatinib and capecitabine in a heavily-pretreated patient with HER2-positive metastatic breast cancer
1 Consultant Physician of Internal Medicine and Medical Oncology, Ambulatory Medicine, Hamad, Medical Corporation, Doha-State of Qatar
2 Pre-college Volunteer Student at London Central Secondary School, Applicant for Medical School at Weill Cornell-Qatar (WCM-Q)
Address correspondence to:
M. S. Ahmed
Consultant Physician of Internal Medicine and Medical Oncology/Ambulatory Medicine, Hamad Medical Corporation, P.O. Box - 3050,
Doha-State of Qatar
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Article ID: 100007C01MA2018
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Ahmed MS, Sadiq YM. Lapatinib and capecitabine in a heavily-pretreated patient with HER2-positive metastatic breast cancer. Edorium J Cancer 2018;4:100007C01MA2018.ABSTRACT
Introduction: Lapatinib is a dual tyrosine kinase inhibitor of both epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor type 2 (HER2 or ErbB2). It is approved in combination with capecitabine for the treatment of HER2-receptor positive advanced or metastatic breast cancer (MBC) that has progressed on trastuzumab therapy.
Case Report: A 49-year-old lady, who was previously treated for right sided breast cancer, presented to the National Centre of Cancer Care and Research in Qatar with local recurrence and multiple metastases to the liver. Her disease progressed within one year of diagnosis despite lumpectomy and adjuvant chemotherapy. For unknown reason, she was not offered adjuvant radiotherapy. HER2-receptor analysis was not available back in her home country and was not accessible for the patient either. The recurrent disease treated with modified radical mastectomy. Surgery was followed by two cycles of Carboplatin and Vinorelbine at first then shifted to a combination of Paclitaxel and Trastuzumab when Her-2 receptor analysis came as 90% positive, and followed by maintenance monotherapy of Trastuzumab for eight cycles. The patient progressed with brain metastases that were treated with whole brain irradiation followed by Lapatinib and Capecitabine combination therapy for a period of 12 months.
Conclusion: Based on this case, medical oncologists would realize the effectivity of lapatinib plus Capecitabine to treat patients with metastatic breast cancer, mainly those with brain metastases, but also to provide stability of other soft tissue metastases. Lapatinib based therapy achieved an excellent control of the brain metastases despite interruption of treatment for two months; a response that is translated into prolonged overall survival and or time to progression.
Keywords: Brain metastases, Capecitabine, HER2-positive metastatic breast cancer, Lapatinib, Trastuzumab
SUPPORTING INFORMATION
Author Contributions
M. S. Ahmed - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Y. M. Sadiq - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Mohammed Sadeq Ahmed et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
