RC0639: Phase II study of paclitaxel, trastuzumab, and lapatinib as adjuvant therapy for early stage HER2-positive breast cancer

Alvaro Moreno-Aspitia, Amylou C. Dueck, Ismael Ghanem-Cañete, Tejal Patel, Shaker Dakhil, David Johnson, Sandra Franco, Stephen Kahanic, Gerardo Colon-Otero, Kathleen S. Tenner, Richard Rodeheffer, Ann E. McCullough, Robert B. Jenkins, Frances M. Palmieri, Donald Northfelt, Edith A. Perez

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Lapatinib adds to the efficacy of trastuzumab in preclinical models and also in the neo-adjuvant setting. This study assesses the safety and feasibility of adding lapatinib to paclitaxel and trastuzumab (THL) as part of the adjuvant therapy for HER2-positive breast cancer (HER2+ BC). In this single-arm phase II study, patients with stages I-III HER2+ BC received standard anthracycline-based chemotherapy followed by weekly taxane, with concurrent standard trastuzumab, plus daily lapatinib for a total of 12 months. The primary endpoint was symptomatic congestive heart failure, secondary endpoints included overall safety. A total of 109 eligible patients were enrolled. Median follow-up is 4.3 years. No patients experienced congestive heart failure while on treatment. Mean left ventricular ejection fraction at baseline and at the end of THL were 63.6 % (N = 109, SD = 5.7) and 59.8 % (N = 98, SD = 8.1), respectively [mean change -3.95 % (N = 98, SD = 8.3), p < 0.001]. One hundred and two patients initiated post-AC treatment; of them, 31 % experienced grade 3 (no G4) diarrhea with lapatinib at 750 mg/day. The addition of lapatinib to paclitaxel and trastuzumab following AC does not add cardiac toxicity. Lapatinib dose of 750 mg/day in combination with standard chemotherapy plus trastuzumab has acceptable overall tolerability.

Original languageEnglish (US)
Pages (from-to)427-435
Number of pages9
JournalBreast Cancer Research and Treatment
Volume138
Issue number2
DOIs
StatePublished - Apr 2013

Keywords

  • Adjuvant
  • Breast cancer
  • Gastrointestinal
  • HER2 cardiac
  • Lapatinib
  • Tolerability

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Moreno-Aspitia, A., Dueck, A. C., Ghanem-Cañete, I., Patel, T., Dakhil, S., Johnson, D., Franco, S., Kahanic, S., Colon-Otero, G., Tenner, K. S., Rodeheffer, R., McCullough, A. E., Jenkins, R. B., Palmieri, F. M., Northfelt, D., & Perez, E. A. (2013). RC0639: Phase II study of paclitaxel, trastuzumab, and lapatinib as adjuvant therapy for early stage HER2-positive breast cancer. Breast Cancer Research and Treatment, 138(2), 427-435. https://doi.org/10.1007/s10549-013-2469-2