Efficacy of second-line treatment with capecitabine and lapatinib in HER2-positive mammary neoplasia, with encephalic metastasis, after first-line therapy with dual anti-HER2 block

Efficacia in II linea del trattamento con capecitabina e lapatinib nella neoplasia mammaria HER2-positiva, con metastasi encefaliche, dopo I linea con do 

Abstract

Lapatinib is a small molecule that reversibly inhibits the tyrosine kinase activity of EGFR and HER2. It is indicated in the treatment of breast carcinoma overexpressing HER2 (ErB2), in combination with capecitabine, in patients with advanced or metastatic disease, progressing after treatment with anthracyclines, taxanes and trastuzumab. We report the case of a 53-year-old patient with hepatic and local disease at diagnosis, treated as first line with trastuzumab, pertuzumab and docetaxel. After 9 months, encephalic progression was documented. The patient was treated with radiotherapy, trastuzumab and pertuzumab. After recurrence of the encephalic disease, the patient started therapy with lapatinib and capecitabine, leading to stable disease at local, hepatic and cerebral level, with an excellent tolerability profile (Oncology).