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Phase I and pharmacological trial of lapatinib in combination with gemcitabine in patients with advanced breast cancer.

R van der Noll ,
W M Smit ,
A N M Wymenga ,
D S Boss ,
M Grob ,
A D R Huitema ,
H Rosing ,
M M Tibben ,
M Keessen ,
H Rehorst ,
J H Beijnen ,
J H M Schellens

Abstract

METHODS

Female patients with advanced BC were given lapatinib once daily (QD) in 28-day cycles with gemcitabine administered on day 1, 8 and 15. Physical examinations, vital signs and blood sampling for hematology, clinical chemistry and pharmacokinetics (PK) and radiological assessments of disease were performed at regular intervals.

CONCLUSION

Despite a slightly increased toxicity profile compared to their respective monotherapies, lapatinib and gemcitabine can be safely combined while showing signs of anti-tumor activity.

RESULTS

In total, 33 patients were included. Six dose-limiting toxicities were observed, mostly grade 3 increases in liver function tests. Most common toxicities were fatigue (73%), nausea (70%), diarrhea (58%), increases in ALAT and ASAT (55 and 52%, respectively) and rash (46%). The maximum tolerated dose was lapatinib 1250 mg QD with gemcitabine 1000 mg/m(2). Lapatinib and gemcitabine PK did not appear to be influenced by each other. Anti-tumor activity was observed with one patient (4%) showing complete response and six (23%) partial response.

BACKGROUND

Lapatinib has proven efficacy as monotherapy and in combination with capecitabine in patients with metastatic breast cancer (MBC) overexpressing HER2 and/or EGFR. Gemcitabine also has anti-tumor activity in MBC and a favourable toxicity profile. In this phase I study lapatinib and gemcitabine were combined.

More about this publication

Investigational new drugs

Volume 33
Issue nr. 6
Pages 1197-205
Publication date 01-12-2015

Full text links

Publisher website (DOI) 10.1007/s10637-015-0281-z
Europe PubMed Central 26362459
Pubmed 26362459

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