| 摘要 |
Lapatinib is a novel treatment option for female breast cancer patients who have
HER2-positive advanced or metastatic breast cancer that has progressed after
previous treatment with other chemotherapeutic agents. We report herein a 50-yearold
perimenopausal female who had Stage IIB, T3N0M0, ER(-), PR(-), Her2(3+)
breast infiltrating ductal carcinoma and had only received adjuvant trastuzumab
therapy every three week of 2,640 mg given in total following skin sparing
mastectomy with immediate tissue expander reconstruction on March 2nd, 2007.
Her overall responses to trastuzumab were good until liver metastases were
discovered in June, 2008. Due to hepatic failure, instead of chemotherapy we tried
lapatinib at a dose lower than recommended. The patient received 750 mg/m2/day of
lapatinib for the first week, along with capecitabine (1,250 mg/m2) twice a day. Her
liver function showed improvement after one week of therapy, therefore we
increased the dose of lapatinib to 1,000 mg/m2/day. A month later, the number of
metastasis tumors remained stationary in numbers, but most of the
lymphadenopathy was less obvious and almost invisible. Four months later,
significant shrinkage of the pre-existing hepatic metastases was observed, and some
of the tumors were no longer detected which reflected complete remission from those
tumors. This present case corresponds with the previous evidence that lapatinib has
clinical activity in HER2-overexpressing breast cancer that is not responsive to
trastuzumab-containing therapy. Future studies regarding the impact of lapatinib on
earlier stages of breast cancer, as well as its application as first-line therapy, are
warranted. |
