Long-Term Disease Control with Lapatinib and Capecitabine in a Heavily Pretreated Patient with ErbB2-Positive Metastatic Breast Cancer.

Background: The optimal sequence of systemic palliative chemotherapy in metastatic breast cancer is unknown. CASE REPORT: We report the course of disease in a patient aged 24 years at the onset of disease, who was treated over 17 years for her metastatic ErbB2-positive breast cancer. Seventeen years ago, the patient was diagnosed to have invasive ductal breast cancer and underwent surgical treatment. She received 6 cycles of adjuvant chemotherapy with CMF (cyclophosphamide, methotrexate, 5-fluorouracil). Twenty-eight months after the primary surgery, the patient developed a histologically verified lung metastasis, and subsequently received 8 different lines of chemotherapy, including high-dose cytotoxic therapy and stem cell support as well as trastu-zumab. In addition, she received 5 different types of antihormonal treatment. Due to the recent progression of her lung metastasis, 27 cycles of lapatinib and capecitabine were administered. A long-term partial response in the lung was observed.

Conclusions: Individualized systemic treatment with the tyrosine kinase inhibitor lapatinib and capecitabine in heavily pretreated patients with Her2-positive metastatic breast cancer may lead to effective palliation for almost 2 years despite extensive pretreatment.