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Lapatinib

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Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 201))

Abstract

The human epidermal growth factor receptor (HER) family of receptor tyrosine kinases plays an important role in the biology of many cancers. In breast and gastric cancer, and maybe also additional tumor types, HER2 and its homo- or heterodimerization with HER1 or HER3 are essential for cancer cell growth and survival. Breast cancer patients overexpressing HER2 have a poor prognosis, which can be substantially improved upon HER2-targeted therapy using the monoclonal antibody trastuzumab. Lapatinib is a dual tyrosine kinase inhibitor (TKI), blocking HER1 and HER2 tyrosine kinase activity by binding to the ATP-binding site of the receptor’s intracellular domain. This results in the inhibition of tumor cell growth. In patients, the drug is relatively well tolerated with mostly low-grade adverse effects. In particular and unlike to trastuzumab, it has very little, if any, adverse effects on cardiac function. In 2007, lapatinib has been approved in combination with capecitabine in patients with advanced HER2-positive breast cancer upon progressive disease following standard therapy with anthracyclines, taxanes, and trastuzumab. In 2010, the approval was extended to the treatment of postmenopausal women with advanced, hormone receptor- and HER2-positive breast cancer, for whom hormonal therapy is indicated. Ongoing and future studies will explore its role in the (neo)adjuvant therapy setting, in further drug combinations as well as in the treatment of HER2-positive tumors other than breast cancer.

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References

  • Bang Y (2012) A randomized, open-label, phase III study of lapatinib in combination with weekly paclitaxel versus weekly paclitaxel alone in the second-line treatment of HER2 amplified advanced gastric cancer (AGC) in Asian population: Tytan study. J Clin Oncol 30(34):11

    Article  Google Scholar 

  • Bang YJ, Van Cutsem E et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376(9742):687–697

    Article  CAS  PubMed  Google Scholar 

  • Baselga J, Bradbury I et al (2012) Lapatinib with trastuzumab for HER2-positive early breast cancer (NeoALTTO): a randomised, open-label, multicentre, phase 3 trial. Lancet 379(9816):633–640

    Article  CAS  PubMed  Google Scholar 

  • Bence AK, Anderson EB et al (2005) Phase I pharmacokinetic studies evaluating single and multiple doses of oral GW572016, a dual EGFR-ErbB2 inhibitor, in healthy subjects. Invest New Drugs 23(1):39–49

    Article  CAS  PubMed  Google Scholar 

  • Blackwell K, Kaplan E et al (2004) A phase II, open-label, multicenter study of GW572016 in patients with trastuzumab-refractory metastatic breast cancer. J Clin Oncol 22(3006)

    Google Scholar 

  • Blackwell KL, Burstein HJ et al (2010) Randomized study of Lapatinib alone or in combination with trastuzumab in women with ErbB2-positive, trastuzumab-refractory metastatic breast cancer. J Clin Oncol 28(7):1124–1130

    Article  CAS  PubMed  Google Scholar 

  • Boku N (2013) HER2-positive gastric cancer. Gastric Cancer (Epub ahead of print)

    Google Scholar 

  • Burris HA 3rd (2004) Dual kinase inhibition in the treatment of breast cancer: initial experience with the EGFR/ErbB-2 inhibitor lapatinib. Oncologist 9(Suppl 3):10–15

    Article  CAS  PubMed  Google Scholar 

  • Burris HA 3rd, Hurwitz HI et al (2005) Phase I safety, pharmacokinetics, and clinical activity study of lapatinib (GW572016), a reversible dual inhibitor of epidermal growth factor receptor tyrosine kinases, in heavily pretreated patients with metastatic carcinomas. J Clin Oncol 23(23):5305–5313

    Article  CAS  PubMed  Google Scholar 

  • Cameron D, Casey M et al (2008) 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 Res Treat 112(3):533–543

    Article  CAS  PubMed  Google Scholar 

  • Cameron D, Casey M et al (2010) Lapatinib plus capecitabine in women with HER-2-positive advanced breast cancer: final survival analysis of a phase III randomized trial. Oncologist 15(9):924–934

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Chen C, Yang JM et al (2013) Prognostic role of human epidermal growth factor receptor in gastric cancer: a systematic review and meta-analysis. Arch Med Res 44(5):380–389

    Article  CAS  PubMed  Google Scholar 

  • Chu QS, Schwartz G et al (2007) Phase I and pharmacokinetic study of lapatinib in combination with capecitabine in patients with advanced solid malignancies. J Clin Oncol 25(24):3753–3758

    Google Scholar 

  • Chu QS, Cianfrocca ME et al (2008) A phase I and pharmacokinetic study of lapatinib in combination with letrozole in patients with advanced cancer. Clin Cancer Res 14(14):4484–4490

    Article  CAS  PubMed  Google Scholar 

  • Citri A, Yarden Y (2006) EGF-ERBB signalling: towards the systems level. Nat Rev Mol Cell Biol 7(7):505–516

    Article  CAS  PubMed  Google Scholar 

  • Clayton AJ, Danson S et al (2004) Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer. Br J Cancer 91(4):639–643

    CAS  PubMed Central  PubMed  Google Scholar 

  • Danielsen AJ, Maihle NJ (2002) The EGF/ErbB receptor family and apoptosis. Growth Factors 20(1):1–15

    Article  CAS  PubMed  Google Scholar 

  • Di Leo A, Gomez HL et al (2008) Phase III, double-blind, randomized study comparing lapatinib plus paclitaxel with placebo plus paclitaxel as first-line treatment for metastatic breast cancer. J Clin Oncol 26(34):5544–5552

    Article  PubMed Central  PubMed  Google Scholar 

  • Esteva FJ, Franco SX et al (2013) An open-label safety study of lapatinib plus trastuzumab plus paclitaxel in first-line HER2-positive metastatic breast cancer. Oncologist 18(6):661–666

    Article  CAS  PubMed  Google Scholar 

  • Frassoldati A, Guarneri V et al (2008) Letrozole versus letrozole plus Lapatinib (GW572016) in hormone-sensitive, HER2-negative operable breast cancer: a double-blind, randomized, phase II study with biomarker evaluation (EGF109077- LAP107692/LETLOB). Clin Breast Cancer 8(1):97–100

    Google Scholar 

  • Gelmon KA, Boyle F et al. (2012) 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. J Clin Oncol 30: 812. (ASCO Annual Meeting Abstracts) (LBA671)

    Google Scholar 

  • Geyer CE, Forster J et al (2006) Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 355(26):2733–2743

    Article  CAS  PubMed  Google Scholar 

  • GlaxoSmithKline (2007) Lapatinib (package insert)

    Google Scholar 

  • GlaxoSmithKline (2013) Lapatinib plus capecitabine versus trastuzumab plus capecitabine in ErbB2 (HER2) positive metastatic breast cancer. From http://clinicaltrials.gov/show/NCT00820222

  • Gomez HL, Doval DC et al (2008) Efficacy and safety of lapatinib as first-line therapy for ErbB2-amplified locally advanced or metastatic breast cancer. J Clin Oncol 26(18):2999–3005

    Google Scholar 

  • Goss PE, Smith IE et al (2012) Adjuvant lapatinib for women with early-stage HER2-positive breast cancer: a randomised, controlled, phase 3 trial. Lancet Oncol 14(1):88–96

    Article  PubMed  Google Scholar 

  • Graus-Porta D, Beerli RR et al (1997) ErbB-2, the preferred heterodimerization partner of all ErbB receptors, is a mediator of lateral signaling. EMBO J 16(7):1647–1655

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Gril B, Palmieri D et al (2008) Effect of lapatinib on the outgrowth of metastatic breast cancer cells to the brain. J Natl Cancer Inst 100(15):1092–1103

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Guan Z, Xu B et al (2013) Randomized trial of lapatinib versus placebo added to paclitaxel in the treatment of human epidermal growth factor receptor 2-overexpressing metastatic breast cancer. J Clin Oncol 31(16):1947–1953

    Article  CAS  PubMed  Google Scholar 

  • Guarneri V, Frassoldati A et al (2012) Preoperative chemotherapy plus trastuzumab, lapatinib, or both in human epidermal growth factor receptor 2-positive operable breast cancer: results of the randomized phase II CHER-LOB study. J Clin Oncol 30(16):1989–1995

    Google Scholar 

  • Hecht J R, Y J Bang et al (2013) Lapatinib in combination with capecitabine plus oxaliplatin (CapeOx) in HER2-positive advanced or metastatic gastric, esophageal, or gastroesophageal adenocarcinoma (AC): The TRIO-013/LOGiC Trial. J Clin Oncol 31(18):abstract-LBA4001 [ASCO Annual Meeting Proceedings (Post-Meeting Edition)]

    Google Scholar 

  • Hong L, Han Y et al (2013) Prognostic value of epidermal growth factor receptor in patients with gastric cancer: a meta-analysis. Gene 529(1):69–72

    Article  CAS  PubMed  Google Scholar 

  • Horn L, Lovly C (2012) Update on HER1-3 in advanced non-small-cell lung cancer. J Thorac Oncol 7(16):S369–S371

    Article  PubMed  Google Scholar 

  • Iqbal S, Goldman B et al. (2007). S0413: a phase II SWOG study of GW572016 (lapatinib) as first line therapy in patients with advanced or metastatic gastric cancer. J Clin Oncol 25(18):4621 (ASCO Annual Meeting Proceedings (Post-Meeting Edition))

    Google Scholar 

  • Johnston S, Pippen J Jr et al (2009) Lapatinib combined with letrozole versus letrozole and placebo as first-line therapy for postmenopausal hormone receptor-positive metastatic breast cancer. J Clin Oncol 27(33):5538–5546

    Article  CAS  PubMed  Google Scholar 

  • Kim JW, Kim HP et al (2008) The growth inhibitory effect of lapatinib, a dual inhibitor of EGFR and HER2 tyrosine kinase, in gastric cancer cell lines. Cancer Lett 272(2):296–306

    Article  CAS  PubMed  Google Scholar 

  • Klapper LN, Kirschbaum MH et al (2000) Biochemical and clinical implications of the ErbB/HER signaling network of growth factor receptors. Adv Cancer Res 77:25–79

    Article  CAS  PubMed  Google Scholar 

  • Kohler J, Schuler M (2013) Afatinib, Erlotinib and Gefitinib in the first-line therapy of EGFR mutation-positive lung adenocarcinoma: a review. Onkologie 36(9):510–518

    Article  PubMed  Google Scholar 

  • Konecny GE, Pegram MD et al (2006) Activity of the dual kinase inhibitor lapatinib (GW572016) against HER-2-overexpressing and trastuzumab-treated breast cancer cells. Cancer Res 66(3):1630–1639

    Article  CAS  PubMed  Google Scholar 

  • Lin NU, Winer EP (2004) New targets for therapy in breast cancer: small molecule tyrosine kinase inhibitors. Breast Cancer Res 6(5):204–210

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Lin NU, Carey LA et al (2008) Phase II trial of lapatinib for brain metastases in patients with human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 26(12):1993–1999

    Article  CAS  PubMed  Google Scholar 

  • Lin NU, Dieras V et al (2009) Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res 15(4):1452–1459

    Article  CAS  PubMed  Google Scholar 

  • Lin NU, Eierman W et al (2011) Randomized phase II study of lapatinib plus capecitabine or lapatinib plus topotecan for patients with HER2-positive breast cancer brain metastases. J Neurooncol 105(3):613–620

    Google Scholar 

  • Medina PJ, Goodin S (2008) Lapatinib: a dual inhibitor of human epidermal growth factor receptor tyrosine kinases. Clin Ther 30(8):1426–1447

    Article  CAS  PubMed  Google Scholar 

  • Mendelsohn J, Baselga J (2003) Status of epidermal growth factor receptor antagonists in the biology and treatment of cancer. J Clin Oncol 21(14):2787–2799

    Article  CAS  PubMed  Google Scholar 

  • Moy B, Goss PE (2007) Lapatinib-associated toxicity and practical management recommendations. Oncologist 12(7):756–765

    Article  CAS  PubMed  Google Scholar 

  • Nahleh ZA (2008) Molecularly targeted therapy in breast cancer: the new generation. Recent Patents Anticancer Drug Discov 3(2):100–104

    Article  CAS  Google Scholar 

  • Nahta R, Hortobagyi GN et al (2003) Growth factor receptors in breast cancer: potential for therapeutic intervention. Oncologist 8(1):5–17

    Article  CAS  PubMed  Google Scholar 

  • Nelson MH, Dolder CR (2006) Lapatinib: a novel dual tyrosine kinase inhibitor with activity in solid tumors. Ann Pharmacother 40(2):261–269

    Article  CAS  PubMed  Google Scholar 

  • Okano J, Gaslightwala I et al (2000) Akt/protein kinase B isoforms are differentially regulated by epidermal growth factor stimulation. J Biol Chem 275(40):30934–30942

    Article  CAS  PubMed  Google Scholar 

  • Olayioye MA, Neve RM et al (2000) The ErbB signaling network: receptor heterodimerization in development and cancer. EMBO J 19(13):3159–3167

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Perez EA, Koehler M et al (2008) Cardiac safety of lapatinib: pooled analysis of 3689 patients enrolled in clinical trials. Mayo Clin Proc 83(6):679–686

    Article  PubMed  Google Scholar 

  • Piccart-Gebhart MJ, Procter M et al (2005) Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 353(16):1659–1672

    Article  CAS  PubMed  Google Scholar 

  • Prenzel N, Fischer OM et al (2001) The epidermal growth factor receptor family as a central element for cellular signal transduction and diversification. Endocr Relat Cancer 8(1):11–31

    Article  CAS  PubMed  Google Scholar 

  • Rahman A, Pazdur R et al (2007) The value meal: effect of food on lapatinib bioavailability. J Clin Oncol 25(33):5333–5335

    Article  PubMed  Google Scholar 

  • Rana P, Sridhar SS (2012) Efficacy and tolerability of lapatinib in the management of breast cancer. Breast Cancer (Auckl) 6:67–77

    Google Scholar 

  • Rapidis AD, Vermorken JB et al (2008) Targeted therapies in head and neck cancer: past, present and future. Rev Recent Clin Trials 3(3):156–166

    Article  CAS  PubMed  Google Scholar 

  • Ratain MJ, Cohen EE (2007) The value meal: how to save $1,700 per month or more on lapatinib. J Clin Oncol 25(23):3397–3398

    Article  PubMed  Google Scholar 

  • Rivera F, Vega-Villegas ME et al (2008) Cetuximab, its clinical use and future perspectives. Anticancer Drugs 19(2):99–113

    Article  CAS  PubMed  Google Scholar 

  • Robidoux A, Tang G et al (2012) Evaluation of lapatinib as a component of neoadjuvant therapy for HER2+ operable breast cancer: NSABP protocol B-41. J Clin Oncol 30:812 (ASCO Annual Meeting Abstract LBA506)

    Google Scholar 

  • Romond EH, Perez EA et al (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353(16):1673–1684

    Article  CAS  PubMed  Google Scholar 

  • Scaltriti M, Verma C et al (2009) Lapatinib, a HER2 tyrosine kinase inhibitor, induces stabilization and accumulation of HER2 and potentiates trastuzumab-dependent cell cytotoxicity. Oncogene 28(6):803–814

    Article  CAS  PubMed  Google Scholar 

  • Singh BN, Malhotra BK (2004) Effects of food on the clinical pharmacokinetics of anticancer agents: underlying mechanisms and implications for oral chemotherapy. Clin Pharmacokinet 43(15):1127–1156

    Article  CAS  PubMed  Google Scholar 

  • Sliwkowski MX (2003) Ready to partner. Nat Struct Biol 10(3):158–159

    Article  CAS  PubMed  Google Scholar 

  • Stebbing J, Copson E et al (2000) Herceptin (trastuzamab) in advanced breast cancer. Cancer Treat Rev 26(4):287–290

    Article  CAS  PubMed  Google Scholar 

  • Stern DF (2000) Tyrosine kinase signalling in breast cancer: ErbB family receptor tyrosine kinases. Breast Cancer Res 2(3):176–183

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Stern HM (2012) Improving treatment of HER2-positive cancers: opportunities and challenges. Sci Transl Med 4(127):127rv2

    Google Scholar 

  • Tomasello G, de Azambuja E et al (2008) Jumping higher: is it still possible? The ALTTO trial challenge. Expert Rev Anticancer Ther 8(12):1883–1890

    Article  CAS  PubMed  Google Scholar 

  • Untch M, Loibl S et al (2012) Lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-taxane-based chemotherapy (GeparQuinto, GBG 44): a randomised phase 3 trial. Lancet Oncol 13(2):135–144

    Article  CAS  PubMed  Google Scholar 

  • Wainberg ZA, Anghel A et al (2010) Lapatinib, a dual EGFR and HER2 kinase inhibitor, selectively inhibits HER2-amplified human gastric cancer cells and is synergistic with trastuzumab in vitro and in vivo. Clin Cancer Res 16(5):1509–1519

    Article  CAS  PubMed  Google Scholar 

  • Witton CJ, Reeves JR et al (2003) Expression of the HER1-4 family of receptor tyrosine kinases in breast cancer. J Pathol 200(3):290–297

    Article  CAS  PubMed  Google Scholar 

  • Wood ER, Truesdale AT et al (2004) A unique structure for epidermal growth factor receptor bound to GW572016 (Lapatinib): relationships among protein conformation, inhibitor off-rate, and receptor activity in tumor cells. Cancer Res 64(18):6652–6659

    Article  CAS  PubMed  Google Scholar 

  • Xia W, Liu LH et al (2004) 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 23(3):646–653

    Article  CAS  PubMed  Google Scholar 

  • Xia W, Gerard CM et al (2005) Combining lapatinib (GW572016), a small molecule inhibitor of ErbB1 and ErbB2 tyrosine kinases, with therapeutic anti-ErbB2 antibodies enhances apoptosis of ErbB2-overexpressing breast cancer cells. Oncogene 24(41):6213–6221

    Article  CAS  PubMed  Google Scholar 

  • Yarden Y, Sliwkowski MX (2001) Untangling the ErbB signalling network. Nat Rev Mol Cell Biol 2(2):127–137

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Martin Trepel .

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Nolting, M., Schneider-Merck, T., Trepel, M. (2014). Lapatinib. In: Martens, U. (eds) Small Molecules in Oncology. Recent Results in Cancer Research, vol 201. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54490-3_7

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