Combining Paclitaxel and Lapatinib as Second-line Treatment for Patients with Metastatic Transitional Cell Carcinoma: A Case Series

• Published in: Anticancer research Vol. 32; no. 9; pp. 3949 - 3952
• Main Authors: CULINE, Stephane, SELLAM, Zineb, BOUAITA, Linda, ASSAF, Elias, DELBALDO, Catherine, VERLINDE-CARVALHO, Muriel, POUESSEL, Damien
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.09.2012
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Carcinoma, Transitional Cell - drug therapy; Carcinoma, Transitional Cell - pathology; Humans; Male; Medical sciences; Middle Aged; Neoplasm Metastasis; Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Quinazolines - administration & dosage; Quinazolines - adverse effects; Salvage Therapy; Tumors; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - pathology; Urologic Neoplasms - drug therapy; Urologic Neoplasms - pathology; Antineoplastic agent; Human; Enzyme; Tyrosine kinase inhibitor; case series; Transferases; Enzyme inhibitor; Malignant tumor; Transitional cell carcinoma; Metastasis; Cancerology; Taxane derivatives; Paclitaxel; Advanced stage; Second line treatment; Lapatinib; Salvage treatment; salvage therapy; Antimitotic; Protein-tyrosine kinase; Cancer
• ISSN: 0250-7005; 1791-7530

Current first-line cisplatin-based combination chemotherapy regimens provide interesting response rates but limited impact on survival for patients with metastatic transitional cell carcinoma of the urothelium. Such results leave a significant patient population in need of salvage therapy. As the epidermal growth factor receptors 1 and 2 (EGFR and HER2) are frequently overexpressed in urothelial carcinoma, we explored the feasibility of a combination of paclitaxel (80 mg/m(2)/week) and lapatinib (1,500 mg orally daily) for six patients who were treated after failure of first-line platinum-based chemotherapy. Only one out of six patients was able to receive the full doses during the first six weeks of treatment, while grade 2 or 3 diarrhea events required lapatinib dose reduction (one patient) or discontinuation (five patients), despite loperamide support. This combination is not recommended for this population of patients.