A combination of lapatinib, trastuzumab and paclitaxel significantly improved tumour response rates compared to either agent alone among patients with HER2-positive breast cancers, according to data presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 8-12.

Lead researcher José Baselga, associate director of the Massachusetts General Hospital Cancer Center, said early data indicate a 51.3 percent rate of pathological complete remission¹ compared with 29.5 percent for trustuzumab and 24.7 percent for lapatinib, used in the neoadjuvant setting, before surgery. Data was taken at 18 weeks of treatment, just before surgery on the tumour.

"This study suggests that a dual blockade against HER2 is an efficient way to target HER2-positive breast tumours and that lapatinib adds to trastuzumab. While further research is ongoing, our results indicate that we are on the right track to improve the therapy of HER2-positive disease," said Baselga, who is also a founding editor-in-chief of the AACR's newest journal Cancer Discovery, along with Lewis C. Cantley, Ph.D.

These results are from the NeoALTTO* Trial, an international, multicenter, randomized study comparing the efficacy of lapatinib plus paclitaxel vs. trastuzumab plus paclitaxel vs. a combination of all three agents as neoadjuvant chemotherapy among 455 patients with HER2-positive breast cancer.

"It has been suggested in basic science research and smaller clinical trials that the combination of these therapies would be more effective than either alone, but this is the first time it has been shown in a large clinical trial setting. It has been proven a valid therapy for HER2-postitive breast cancer. Based on our experience with Herceptin and adjuvant trials such as ALLTO² there is the potential here fro curing 90+ percent of HER2-positive breast cancer patients; those who once had a bad prognosis" said Baselga. "Although the combination will cost more, the money saved by avoiding future treatment has to be taken into account", he added.





1. pCR is a reiiable prognostic factor in operated breast cancer patients who have received primary chemotherapy. However, definition of pCR varies among clinical trial groups. In this case it was defined as "the absence of invasive cancer in the breast at the time of surgery".

2. ALTTO stands for Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation

ecancertv interview with Jose Baselga coming Soon