The safety and feasibility of dose dense doxorobicin and cychlophosphomide(AC) fallowed by paclitaxel and trastuzumab and lapatinib an HER-2+ breast cancer

Back ground:Lapatinib is anovel dualkinase inhibitor that targets both HRE2and EFGR tyrosine kinase signaling pathways.Methodes:Here is a review of a polit study of Dose Dense AC fallowed by PTLfallowed by TL patients with stage 1 to 3,HER2+ breast cancer withLVEF=50% or more. Treatment considered of AC (60 mg/m2 and 600mg/m2)×4 cycles every 2 weeks with pegfilgrastim 6mg on day 2 fallowed bypaclitaxel 80mg /m2 ×12 weekly plus trastuzumab and lapatinibtrastuzumab(4mg/kg loadind dose then 2mg/kg weekly during palitaxel then6mg/kg every 3 weeks after paclitaxel) and lapatinib 100mg/d,were given for 1year.The primary end points were feasibility defined as ≥80% patientscompleting PTL phase without a dose delay reduction and safety defined asincidence of cardiac event rate ≤4%.Finding and Results:In studies 45% withdrew for PTL-specific toxicitiesoverall 43% of patients had Lapatinib dose reduction and 29% had grade 3diarrhea.3% had CHF three patients dropped out because of significantasymptomatic LVEF decline during PTL fallowed by TL.Conclusion:TL was not feasible because of a high rate ofèPTLèDose Dence AClapatinib dose reduction mostly caused by grade 3 diarrhea.This drug was notfeasible combined with weekly PT

کلیدواژه ها:

Dose Dense ، Lapatinib ، Trastuzumab