Combination of lapatinib and trastuzumab shrinks HER2 positive breast cancer significantly in 11 days after diagnosis

So far, EPHOS-B is the only trial that has investigated giving combination treatment alone, without chemotherapy, in the two weeks between diagnosis and routine surgery. “Other trials have looked at anti-HER2 therapy, with and without chemotherapy, including an assessment of the combination of trastuzumab and lapatinib, and have reported impressive response rates but these trials have only reported results after several months of therapy.

“Potentially, giving treatment while waiting for surgery can identify a group of patients whose disease is particularly sensitive to anti-HER2 therapy, which would allow individualisation of therapy in women with HER2 positive cancers,” said Professor Bundred.

Chair of EBCC-10, Professor Fatima Cardoso, who is Director of the Breast Unit at the Champalimaud Clinical Centre, Lisbon, Portugal, said: “The results of this important trial confirm previous initial suggestions that most probably there are patients who can be treated with dual-blockade (two anti-HER2 agents simultaneously) alone, without chemotherapy. This study proposes a simple way to identify those patients very early on, which could help spare them unnecessary chemotherapy. What is now indispensable is to confirm if these early responses translate into better or equal long-term survival.”

HER2 positive breast cancer is breast cancer that has a high number of receptors for the human epidermal growth factor (HER2) on the surfaces of the cancer cells. These receptors stimulate the cancer cells to divide and grow. HER2 positive breast cancers tend to grow more quickly than HER2 negative cancers but can be treated with targeted therapies such as trastuzumab and lapatinib.

The study was funded by Cancer Research UK and GlaxoSmithKline and co-sponsored by The Institute of Cancer Research and The University of Manchester / University Hospital of South Manchester NHS Foundation Trust. Lapatinib is now owned by Novartis.

Abstract no: 6 LBA.“Effects of perioperative lapatinib and trastuzumab, alone and in combination, in early HER2+ breast cancer – the UK EPHOS-B trial (CRUK/08/002)”, Thursday, Clinical science symposium: HER2 positive breast cancer, 16.00-17.30hrs, Elicium.

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Combination of lapatinib and trastuzumab shrinks HER2 positive breast cancer significantly in 11 days after diagnosis