Phase i and pharmacological trial of lapatinib in combination with gemcitabine in patients with advanced breast cancer

R. Van Der Noll, W. M. Smit, A. N M Wymenga, D. S. Boss, M. Grob, A. D R Huitema, H. Rosing, M. M. Tibben, M. Keessen, H. Rehorst, J. H. Beijnen, J. H M Schellens*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Summary: Background Lapatinib has proven efficacy as monotherapy and in combination with capecitabine in patients with metastatic breast cancer (MBC) overexpressing HER2 and/or EGFR. Gemcitabine also has anti-tumor activity in MBC and a favourable toxicity profile. In this phase I study lapatinib and gemcitabine were combined. Methods Female patients with advanced BC were given lapatinib once daily (QD) in 28-day cycles with gemcitabine administered on day 1, 8 and 15. Physical examinations, vital signs and blood sampling for hematology, clinical chemistry and pharmacokinetics (PK) and radiological assessments of disease were performed at regular intervals. Results In total, 33 patients were included. Six dose-limiting toxicities were observed, mostly grade 3 increases in liver function tests. Most common toxicities were fatigue (73 %), nausea (70 %), diarrhea (58 %), increases in ALAT and ASAT (55 and 52 %, respectively) and rash (46 %). The maximum tolerated dose was lapatinib 1250 mg QD with gemcitabine 1000 mg/m2. Lapatinib and gemcitabine PK did not appear to be influenced by each other. Anti-tumor activity was observed with one patient (4 %) showing complete response and six (23 %) partial response. Conclusion Despite a slightly increased toxicity profile compared to their respective monotherapies, lapatinib and gemcitabine can be safely combined while showing signs of anti-tumor activity.

Original languageEnglish
Pages (from-to)1197-1205
Number of pages9
JournalInvestigational New Drugs
Issue number6
Publication statusPublished - 1 Dec 2015


  • Advanced breast cancer
  • Gemcitabine
  • Lapatinib
  • Phase I trial


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