Open AccessPredictive Factors of Lapatinib and Capecitabine Activity in Patients with HER2-Positive, Trastuzumab-Resistant Metastatic Breast Cancer: Results from the Italian Retrospective Multicenter HERLAPAC Study
Author(s) -
Stefania Gori,
Alessandro Inno,
Valentina Rossi,
Monica Turazza,
Elena Fiorio,
Alessandra Fabi,
Giancarlo Bisagni,
Jennifer Foglietta,
Daniele Santini,
Ida Pavese,
A. Pellegrino,
Alberto Zambelli,
Patrizia Vici,
V. Leonardi,
Sandro Barni,
Silvana Saracchini,
Giuseppe Bogina,
Fabiana Marchetti,
Simona Duranti,
Gianluigi Lunardi,
Filippo Montemurro
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0156221
Subject(s) - lapatinib , capecitabine , trastuzumab , medicine , metastatic breast cancer , oncology , retrospective cohort study , breast cancer , cancer , colorectal cancer
Background There are no validated predictive markers for lapatinib and capecitabine in patients with trastuzumab-resistant HER2 positive metastatic breast cancer. Methods Data of 148 consecutive patients treated with lapatinib and capecitabine from March 2007 to December 2013 were collected from 13 Italian institutions. Estimates of progression-free survival (PFS) and overall survival (OS) were obtained with the Kaplan-Meier method and compared with logrank test. The association of clinicopathological variables and the outcome was studied by binary logistic regression analysis and Cox proportional hazard analysis. Results At a median follow-up of 41 months, median PFS and OS were 7 and 21 months, respectively. Patents with a PFS longer than 7 months had a significantly longer OS, compared with patients with a PFS equal to or shorter than 7 months (36 vs 15 months; p<0.001). Multivariate analysis revealed the benefit of lapatinib-based therapy in terms of PFS and OS was significantly associated with time-to-progression (TTP) on prior first-line trastuzumab-based therapy. In particular, each additional month on first-line trastuzumab based therapy was associated with a reduction in hazard of progression and death after the initiation of lapatinib-based therapy of 2% and 4%, respectively. Conclusions A longer TTP to first line trastuzumab seems to predict a prolonged PFS and OS with subsequent lapatinib and capecitabine.