Monitoring circulating epithelial tumour cells (CETC) to gauge therapy: in patients with disease progression after trastuzumab persisting CETC can be eliminated by combined lapatinib treatment.

Abstract

BACKGROUND:

In breast cancers, the gene for the growth factor receptor HER2 can be amplified leading to increased aggressiveness and metastasis formation. The monoclonal antibody trastuzumab prolongs relapse-free survival highly significantly but eventually many patients relapse.

METHOD:

In this study, CETC were monitored using the Maintrac method during adjuvant trastuzumab treatment and during subsequent treatment with capecitabine/lapatinib.

RESULTS:

In one patient, trastuzumab led to marginal reduction in CETC with disease progress. The combination of capecitabine/lapatinib was preliminarily capable to eliminate all CETC, however, CETC reappeared. The second patient received adjuvant taxane together with trastuzumab and 1 year of further trastuzumab during which CETC increased. After stopping trastuzumab skin metastases occurred. Capecitabine/lapatinib led to complete CETC elimination with stable disease.

CONCLUSIONS:

In patients with lack of CETC reduction in spite of trastuzumab treatment correlated with disease progression the combination of capecitabine/lapatinib highly efficiently led to rapid elimination of CETC warranting further monitoring during such studies.

• Authors: Oumar Camara, Cornelia Jörke, Ulrike Hammer, Anne Egbe, Carola Rabenstein, Ingo B Runnebaum, Klaus Hoeffken, Katharina Pachmann
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 135 Issue 4 Pg. 643-7 (Apr 2009) ISSN: 1432-1335 [Electronic] Germany
• PMID: 18936973 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Quinazolines
• Lapatinib
• Receptor, ErbB-2
• Trastuzumab

Topics

• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Blood Cells (drug effects, pathology)
• Breast Neoplasms (drug therapy, pathology)
• Disease Progression
• Epithelial Cells (drug effects, pathology)
• Female
• Gene Amplification
• Humans
• Lapatinib
• Monitoring, Physiologic (methods)
• Quinazolines (therapeutic use)
• Receptor, ErbB-2 (genetics)
• Trastuzumab
• Treatment Outcome