Lapatinib, a TKI Dual Inhibitor of Her1 and Her2 Receptors: Review of the Literature

Abstract

Lapatinib ditosylate (Tyverb?) is a potent and selective oral dual receptor tyrosine kinase inhibitor (TKI), preventing autophosphorylation of epidermal growth factor receptor (EGFR/ErbB1) and human epidermal growth factor receptor 2 (HER2/ErbB2) intracellular domain. This interference blocks the Ras/Raf MAPKs and PI3K/Akt pathways, that lead to uncontrolled cellular proliferation and survival. After the demonstration of its effectiveness and safety in HER2-overexpressed breast cancer, in 2007 the US Food and Drug Administration (FDA) approved this molecule in combination with capecitabine, in patients with locally advanced or metastatic disease, that progressed after previous treatment with anthracyclines, taxanes and trastuzumab. In 2010, Lapatinib received approval for the treatment of postmenopausal women with hormone receptor positive metastatic breast cancer in combination with letrozole. The most common adverse events (AE) are: anorexia, insomnia, diarrhea and skin rash and mild cardiovascular toxicity. This paper reviews the most important studies on Lapatinib in advanced breast cancer. However, promising results were recently reported on this drug, also in adjuvant setting and in combination with other target drugs, which warrant further investigation for the future.

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V. Lorusso, I. Marech, M. Giampaglia, A. Gnoni and A. Tinelli, "Lapatinib, a TKI Dual Inhibitor of Her1 and Her2 Receptors: Review of the Literature," Journal of Cancer Therapy, Vol. 3 No. 6, 2012, pp. 1132-1139. doi: 10.4236/jct.2012.36148.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] M. Press, L. Bernstein, P. Thomas, et al., “HER-2/neu Gene Amplification Characterized by Fluorescence in Situ Hybridization: Poor Prognosis in Node-Negative Breast Carcinomas,” Journal of Clinical Oncology, Vol. 15, No. 8, 1997, pp. 2894-2904.
[2] G. Von Minckwitz, A. du Bois, M. Schmidt, et al., “Trastuzumab beyond Progression in Human Epidermal Growth Factor Receptor 2-Positive Advanced Breast Cancer: A German Breast Group/Breast International Group 03-05 Study,” Journal of Clinical Oncology, Vol. 27, 2009, pp. 1999-2006. doi:10.1200/JCO.2008.19.6618
[3] M. Giampaglia, V. E. Chiuri, et al., “Lapatinib in Breast Cancer: Clinical Experiences and Future Perspectives,” Cancer Treatment Reviews, Vol. 36, No. S3, 2010, pp. S72-S79. doi:10.1016/S0305-7372(10)70024-4
[4] W. Xia, L. H. Liu, P. Ho and N. L. Spector, “Truncated ErbB2 Receptor (p95ErbB2) Is Regulated by Heregulin through Heterodimer Formation with ErbB3 Yet Remains Sensitive to the Dual EGFR/ErbB2 Kinase Inhibitor GW572016,” Oncogene, Vol. 23, No. 3, 2004, pp. 646-653.
[5] R. Nahta, L. X. Yuan, Y. Du, et al., “Lapatinib Induces Apoptosis in Trastuzumab-Resistant Breast Cancer Cells: Effects on Insulin-Like Growth Factor 1 Signaling,” Molecular Cancer Therapeutics, Vol. 6, 2007, pp. 667-674. doi:10.1158/1535-7163.MCT-06-0423
[6] A. Mukherjee, A. S. Dhadda, M. Shehata, et al., “Lapatinib: A Tyrosine Kinase Inhibitor with a Clinical Role in Breast Cancer,” Expert Opinion on Pharmacotherapy, Vol. 8, No. 13, 2007, pp. 2189-2204.
[7] E. A. Perez, M. Koehler, J. Byrne et al., “Cardiac Safety of Lapatinib: Pooled Analysis of 3689 Patients Enrolled in Clinical Trials,” Mayo Clinic Proceedings, Vol. 83, No. 6, 2008, pp. 679-686.
[8] G. Arpino, L. Weichmann, C. K. Osborne, et al., “Crosstalk between the Estrogen Receptor and the HER Tyrosine Kinase Receptor Family,” Endocrine Reviews, Vol. 29, 2008, pp. 217-233. doi:10.1210/er.2006-0045
[9] A. Hurtado, K. A. Holmes, T. R. Geistlinger, et al., “Regulation of ERBB2 by Estrogen Receptor-PAX2 Determines Response to Tamoxifen,” Nature, Vol. 456, 2008, pp. 663-666. doi:10.1038/nature07483
[10] Z. Yang, C. J. Barnes and R. Kumar, “Human Epidermal Growth Factor Receptor 2 Status Modulates Subcellular Localization of and Interaction with Estrogen Receptor Alpha in Breast Cancer Cells,” Clinical Cancer Research, Vol. 10, No. 11, 2004, pp. 3621-3628.
[11] L. A. Martin, I. Farmer, S. R. Johnston, et al., “Enhanced Estrogen Receptor (ER) Alpha, ERBB2, and MAPK Signal Transduction Pathways Operate during the Adaptation of MCF-7 Cells to Long Term Estrogen Deprivation,” Journal of Biological Chemistry, Vol. 278, No. 33, 2003, pp. 30458-30468.
[12] S. Massarweh, C. K. Osborne, S. Jiang, et al., “Mechanisms of Tumor Regression and Resistance to Estrogen Deprivation and Fulvestrant in a Model of Estrogen Receptor-Positive, HER-2/neu-Positive Breast Cancer,” Cancer Research, Vol. 66, No. 16, 2006, pp. 8266-8273.
[13] J. Shou, S. Massarweh, C. Osborne, et al., “Mechanisms of Tamoxifen Resistance: Increased Estrogen Receptor-HER2/neu Cross-Talk in ER/HER2-Positive Breast Cancer,” Journal of the National Cancer Institute, Vol. 96, No. 12, 2004, pp. 926-935.
[14] J. R. Mackey, B. Kaufman, M. Clemens, et al., “Trastuzumab Prolongs Progression-Free Survival in Hormone-Dependent and HER2-Positive Metastatic Breast Cancer,” Breast Cancer Research and Treatment, Vol. 100, No. S5, 2006, Abstr 3.
[15] S. Johnston, J. Pippen Jr., et al., “Lapatinib Combined with Letrozole versus Letrozole and Placebo as First-Line Therapy for Postmenopausal Hormone Receptor-Positive Metastatic Breast Cancer,” Journal of Clinical Oncology, Vol. 27, No. 33, 2009, pp. 5538-5546. doi:10.1200/JCO.2009.23.3734
[16] J. Lemieux, M. Clemons, L. Provencher, et al., “The Role of Neoadjuvant HER2-Targeted Therapies in HER2-Overexpressing Breast Cancers,” Current Oncology, Vol. 16, No. 4, 2009, pp. 48-57.
[17] A. U. Buzdar, N. K. Ibrahim, D. Francis, et al., “Significantly Higher Pathologic Complete Remission Rate after Neoadjuvant Therapy with Trastuzumab, Paclitaxel, and Epirubicin Chemotherapy: Results of a Randomized Trial in Human Epidermal Growth Factor Receptor 2-Positive Operable Breast Cancer,” Journal of Clinical Oncology, Vol. 23, No. 16, 2005, pp. 3676-3685.
[18] B. P. Coudert, L. Arnould, L. Moreau, et al., “Preoperative Systemic (Neo-Adjuvant) Therapy with Trastuzumab and Docetaxel for HER2-Overexpressing Stage II or III Breast Cancer: Results of a Multicenter Phase II Trial,” Annals of Oncology, Vol. 17, 2006, pp. 409-414. doi:10.1093/annonc/mdj096
[19] Neo ALTTO (Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) Study, 2010. http://clinicaltrials.gov/ct2/show/NCT00553358
[20] S.-D. Costa, C. Jackisch, et al., “Future Roles of Lapatinib in ErbB2-Positive Breast Cancer: Adjuvant and Neoadjuvant Trials,” Breast Care, Vol. 5, Suppl. 1, 2010, pp. 2-24. doi:10.1159/000285778
[21] F. A. Holmes, Y. M. Nagarwala, V. A. Espina, L. A. Liotta, M. A. Danso, et al., “Correlation of Molecular Effects and Pathologic Complete Response to Preoperative Lapatinib and Trastuzumab, Separately and Combined Prior to Neoadjuvant Breast Cancer Chemotherapy [Abstract],” Journal of Clinical Oncology, Vol. 29, No. 15S, 2011, p. 506.
[22] V. Guarneri, A. Frassoldati, A. Bottini, et al., “Final Results of a Phase II Randomized Trial of Neoadjuvant Anthracycline-Taxane Chemotherapy plus Lapatinib, Trastuzumab, or both in HER2-Positive Breast Cancer (CHER-LOB Trial),” ASCO Annual Meeting 2011, Abstract No. 507.
[23] J. C. N. Chang, I. A. Mayer, A. Forero-Torres, et al. “TBCRC 006: A Multicenter Phase II Study of Neoadjuvant Lapatinib and Trastuzumab in Patients with HER2-Overexpressing Breast Cancer,” ASCO Annual Meeting 2011, Abstract No. 505.
[24] A. Robidoux, G. Tang and P. Rastogi, “Evaluation of Lapatinib as a Component of Neoadjuvant Therapy for HER2+ Operable Breast Cancer: NSABP Protocol B-41,” Journal of Clinical Oncology, Vol. 30, 2012, Abstr. LBA506.
[25] H. Burstein, A. M. Storniolo, S. Franco, et al., “A Phase II, Open-Label, Multi-Center Study of Lapatinib in Two Cohorts of Patients with Advanced or Metastatic Breast Cancer Who Have Progressed While Receiving Trastuzumab-Containing Regimens,” Annals of Oncology, Vol. 15, Suppl 3, 2004, p. 27.
[26] N. U. Lin, V. Dieras, D. Paul, et al., “A Phase II Study of Lapatinib for Brain Metastases in Subjects with ErbB2-Positive Breast Cancer Following Trastuzumab-Based Systemic Therapy and Cranial Radiotherapy,” Proceedings of American Society of Clinical Oncology, Vol. 27, 2007, Abstr 1012.
[27] ALTTO (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) Study, 2010. http://clinicaltrials.gov/ct2/show/NCT00490139
[28] Tykerb Evaluation after Chemotherapy (TEACH), “Lapatinib versus Placebo in Women with Early-Stage Breast Cancer,” 2010. http://clinicaltrials.gov/ct2/show/NCT00374322
[29] C. E. Geyer, J. Forster, D. Lindquist, et al., “Lapatinib plus Capecitabine for HER2-Positive Advanced Breast Cancer,” New England Journal of Medicine, Vol. 355, No. 26, 2006, pp. 2733-2743.
[30] D. Cameron, M. Casey, M. Press, et al., “A Phase III Randomized Comparison of Lapatinib plus Capecitabine versus Capecitabine Alone in Women with Advanced Breast Cancer That Has Progressed on Trastuzumab: Updated Efficacy and Biomarker Analyses,” Breast Cancer Research and Treatment, Vol. 112, No. 3, 2008, pp. 533-543.
[31] G. E. Konecny, M. D. Pegram, N. Venkatesan, et al., “Activity of the Dual Kinase Inhibitor Lapatinib (GW572016) against HER-2-Overexpressing and Trastuzumab-Treated BC Cells,” Cancer Research, Vol. 66, 2006, pp. 1630-1639. doi:10.1158/0008-5472.CAN-05-1182
[32] M. Scaltriti, C. Verma, M. Guzman, et al., “Lapatinib, a HER2 Tyrosine Kinase Inhibitor, Induces Stabilization and Accumulation of HER2 and Potentiates Trastuzumab-Dependent Cell Cytotoxicity,” Oncogene, Vol. 28, No. 6, 2009, pp. 803-814.
[33] K. L. Blackwell, H. J. Burstein, A. M. Storniolo, et al., “Randomized Study of Lapatinib Alone or in Combination with Trastuzumab in Women with ErbB2-Positive, Trastuzumab-Refractory Metastatic Breast Cancer,” Journal of Clinical Oncology, Vol. 28, No. 7, 2010, pp. 1124-1308. doi:10.1200/JCO.2008.21.4437
[34] K. L. Smith, C. Dang and A. Seidman, “Cardiac Dysfunction Associated with Trastuzumab,” Expert Opinion on Drug Safety, Vol. 5, No. 5, 2006, pp. 619-629.
[35] A. Di Leo, H. L. Gomez, Z. Aziz, et al., “Phase III, Double-Blind, Randomized Study Comparing Lapatinib plus Paclitaxel with Placebo plus Paclitaxel as First-Line Treatment for Metastatic Breast Cancer,” Journal of Clinical Oncology, Vol. 26, No. 34, 2008, pp. 5544-5552.
[36] K. L. Blackwell, D. Miles, L. Gianni et al., “Primary Results from EMILIA, a Phase III Study of Trastuzumab Emtansine (T-DM1) versus Capecitabine (X) and Lapatinib (L) in HER2-Positive Locally Advanced Ormetastatic Breast Cancer (MBC) Previously Treated with Trastuzumab (T) and a Taxane,” Journal of Clinical Oncology, Vol. 30, 2012, Abstr LBA1.
[37] K. A. Gelmon, F. Boyle, B. Kaufman et al., “Open-Label Phase III Randomized Controlled Trial Comparing Taxane-Based Chemotherapy (Tax) with Lapatinib (L) or Trastuzumab (T) as First-Line Therapy for Women with HER2+ Metastatic Breast Cancer: Interim Analysis (IA) of NCIC CTG MA.31/GSK EGF 108919,” Journal of Clinical Oncology, Vol. 30, 2012, Abstr LBA671.
[38] N. U. Lin, J. R. Bellon and E. P. Winer, “CNS Metastases in Breast Cancer,” Journal of Clinical Oncology, Vol. 22, 2004, pp. 3608-3617. doi:10.1200/JCO.2004.01.175
[39] D. Khuntia, P. Brown, J. Li and M. P. Mehta, “Whole-Brain Radiotherapy in the Management of Brain Metastasis,” Journal of Clinical Oncology, Vol. 24, No. 8, 2006, pp. 1295-1304. doi:10.1200/JCO.2005.04.6185
[40] A. J. Clayton, S. Danson, S. Jolly, et al., “Incidence of Cerebral Metastases in Patients Treated with Trastuzumab for Metastatic Breast Cancer,” British Journal of Cancer, Vol. 91, No. 4, 2004, pp. 639-643.
[41] J. Stemmler, M. Schmitt, A. Willems, et al., “Brain Metastases in HER2-Overexpressing Metastatic Breast Cancer: Comparative Analysis of Trastuzumab Levels in Serum and Cerebrospinal Fluid,” Journal of Clinical Oncology, Vol. 24, Suppl. 18, 2006.
[42] N. U. Lin, L. A. Carey, M. C. Liu, et al., “Phase II Trial of Lapatinib for Brain Metastases in Patients with Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer,” Journal of Clinical Oncology, Vol. 26, No. 12, 2008, pp. 1993-1999.
[43] N. U. Lin, V. Diéras, D. Paul, et al., “Multicenter Phase II Study of Lapatinib in Patients with Brain Metastases from HER2-Positive Breast Cancer,” Clinical Cancer Research, Vol. 15, No. 4, 2009, pp. 1452-1459. doi:10.1158/1078-0432.CCR-08-1080

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