Lapatinib and capecitabine efficacy at systemic and encephalic level in a patient progressed after dual block of HER2 by trastuzumab and pertuzumab and after T-DM1

We report the case of a patient with a stage IV ab initio HR-/HER2 positive breast cancer. The patient, treated with pertuzumab and trastuzumab for approximately 8 months, developed a progression of both systemic and cerebral disease. Subsequent treatment with T-DM1 obtained disease control for about 10 months. Afterwards we suggested a therapy based on lapatinib and capecitabine with a clear lasting response at encephalic level. This clinical case suggests that the combination of lapatinib + capecitabine is a valid option in case of double-block progression of HER2 and T-DM1. The interesting activity of lapatinib at encephalic level indicates the drug as one of the best therapeutic options available today in this patient setting (Oncology)