Abstract
In spite of the poorer prognosis of patients with breast cancer with increased HER2 expression it is possible to use biological treatment with the monoclonal antibody targeting HER2 trastuzumab or tyrosine kinase inhibitor lapatinib in their treatment. Both agents block HER2 downstream signalling cascade (in addition, lapatinib inhibits the EGFR signalling pathway), resulting in inhibition of tumour cell proliferation, invasion and metastasis.
The efficacy and suitability of the administration of lapatinib was shown in patients with hormone-dependent metastatic breast cancer with HER2 overexpression who were without rapid disease progression and without symptoms or without visceral metastases (lapatinib in combination with letrozole), and in second-line palliative treatment after trastuzumab failure (lapatinib in combination with capecitabine). Neoadjuvant treatment using the combination of trastuzumab and lapatinib seems to be promising especially in patients with contraindicated chemotherapy (NeoALTTO trial).
As demonstrated in the LANDSCAPE study, lapatinib may also be of benefit in patients with brain metastases because of its small molecule.