Novel Approaches to Advanced Breast Cancer: Bevacizumab and Lapatinib

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Erica L. Mayer From the Dana-Farber Cancer Institute, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts.

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Nancy U. Lin From the Dana-Farber Cancer Institute, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts.

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Harold J. Burstein From the Dana-Farber Cancer Institute, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts.

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New biological therapies continue to emerge in breast cancer. Recent advances with anti-angiogenesis therapies and anti-HER2 therapies highlight the next generation of treatments that will be entering clinical practice. Important questions regarding these targeted treatments remain, however. There are uncertainties as to how best to integrate new drugs into existing treatment algorithms, whether to use monotherapy or combination therapy with chemotherapy, and how to manage novel side effects seen with these agents. This review highlights recent advances with the anti-vascular endothelial growth factor antibody, bevacizumab, and the dual-kinase inhibitor, lapatinib, in the treatment of metastatic breast cancer.

Correspondence: Harold J. Burstein, MD, PhD, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115. E-mail: hburstein@partners.org
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  • 1.

    Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med 1971;285:11821186.

  • 2.

    Rosen LS. VEGF-targeted therapy: therapeutic potential and recent advances. Oncologist 2005;10:382391.

  • 3.

    Dvorak HF, Brown LF, Detmar M, Dvorak AM. Vascular permeability factor/vascular endothelial growth factor, microvascular hyperpermeability, and angiogenesis. Am J Pathol 1995;146:10291039.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Brown LF, Berse B, Jackman RW et al.. Expression of vascular permeability factor (vascular endothelial growth factor) and its receptors in breast cancer. Hum Pathol 1995;26:8691.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Guidi AJ, Fischer L, Harris JR, Schnitt SJ. Microvessel density and distribution in ductal carcinoma in situ of the breast. J Natl Cancer Inst 1994;86:614619.

  • 6.

    Guidi AJ, Schnitt SJ, Fischer L et al.. Vascular permeability factor (vascular endothelial growth factor) expression and angiogenesis in patients with ductal carcinoma in situ of the breast. Cancer 1997;80:19451953.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Weidner N, Folkman J, Pozza F et al.. Tumor angiogenesis: a new significant and independent prognostic indicator in early-stage breast carcinoma. J Natl Cancer Inst 1992;84:18751887.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Weidner N, Semple JP, Welch WR, Folkman J. Tumor angiogenesis and metastasis—correlation in invasive breast carcinoma. N Engl J Med 1991;324:18.

  • 9.

    Linderholm BK, Lindh B, Beckman L et al.. Prognostic correlation of basic fibroblast growth factor and vascular endothelial growth factor in 1307 primary breast cancers. Clin Breast Cancer 2003;4:340347.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Willett CG, Boucher Y, di Tomaso E et al.. Direct evidence that the VEGF-specific antibody bevacizumab has antivascular effects in human rectal cancer. Nat Med 2004;10:145147.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Hurwitz H, Fehrenbacher L, Novotny W et al.. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350:23352342.

  • 12.

    Sandler A, Gray R, Brahmer J et al.. Randomized phase II/III Trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC # 704865) in patients with advanced non-squamous non-small cell lung cancer (NSCLC): an Eastern Cooperative Oncology Group (ECOG) Trial—E4599 [abstract]. J Clin Oncol 2005;23(Suppl 16):Abstract LBA4.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Yang JC, Haworth L, Sherry RM et al.. A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med 2003;349:427434.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Miller K, Wang M, Gralow J et al.. E2100: a randomized phase III trial of paclitaxel versus paclitaxel plus bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 7001.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Cobleigh MA, Langmuir VK, Sledge GW et al.. A phase I/II dose-escalation trial of bevacizumab in previously treated metastatic breast cancer. Semin Oncol 2003;30(suppl 16):117124.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Burstein H, Parker LM, Savoie J et al.. Phase II trial of the anti-VEGF antibody bevacizumab in combination with vinorelbine for refractory advanced breast cancer. Breast Cancer Res Treat 2002;76(suppl 1):S115.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Ramaswamy B, Elias AD, Kelbick NT et al.. Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients. Clin Cancer Res 2006;12:31243129.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Burstein HJ, Spigel D, Kindsvogel K et al.. Metronomic chemotherapy with and without bevacizumab for advanced breast cancer: a randomized phase II study. Breast Cancer Res Treat 2005;94(supp 1):S6.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Traina TA, Rugo H, Caravelli J et al.. Letrozole (L) with bevacizumab (B) is feasible in patients (pts) with hormone receptor-positive metastatic breast cancer (MBC) [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract 3050.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Pegram M, Yeon C, Ku N et al.. Phase I combined biological therapy of breast cancer using two humanized monoclonal antibodies directed against HER2 proto-oncogene and vascular endothelial growth factor (VEGF). Breast Cancer Res Treat 2004;88(supp 1):S124125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Miller KD, Chap LI, Holmes FA et al.. Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol 2005;23:792799.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Miller KD, Wang M, Gralow J et al.. A randomized phase III trial of paclitaxel versus paclitaxel plus bevacizumab as first-line therapy for locally recurrent or metastatic breast cancer: a trial coordinated by the Eastern Cooperative Oncology Group (E2100). Breast Cancer Res Treat 2005;94:S6.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Overmoyer B, Silverman P, Leeming R et al.. Phase II trial of neoadjuvant docetaxel with or without bevacizumab in patients with locally advanced breast cancer. Breast Cancer Res Treat 2004;88(suppl 1):S106.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Wedam SB, Low JA, Yang SX et al.. Antiangiogenic and antitumor effects of bevacizumab in patients with inflammatory and locally advanced breast cancer. J Clin Oncol 2006;24:769777.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Motzer RJ, Hutson TE, Tomczak P et al.. Phase III randomized trial of sunitinib malate (SU11248) versus interferon-alfa (IFN-α) as first-line systemic therapy for patients with metastatic renal cell carcinoma (mRCC) [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract LBA3.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Demetri GD, van Oosterom AT, Blackstein M et al.. Phase 3, multicenter, randomized, double-blind, placebo-controlled trial of SU11248 in patients (pts) following failure of imatinib for metastatic GIST [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 4000.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Escudier B, Szczylik C, Eisen T et al.. Randomized Phase III trial of the Raf kinase and VEGFR inhibitor sorafenib (BAY 43-9006) in patients with advanced renal cell carcinoma (RCC) [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 4510.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Miller KD, Burstein HJ, Elias AD et al.. Phase II study of SU11248, a multitargeted tyrosine kinase inhibitor (TKI) in patients (pts) with previously treated metastatic breast cancer (MBC). Breast Cancer Res Treat 2005;94:S61.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Moreno-Aspitia A, Hillman DW, Wiesenfeld M et al.. BAY 43-9006 as single oral agent in patients with metastatic breast cancer previously exposed to anthracycline and/or taxane [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract 577.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Tsuda H, Takarabe T, Hasegawa T et al.. Myoepithelial differentiation in high-grade invasive ductal carcinomas with large central acellular zones. Hum Pathol 1999;30:11341139.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Coussens L, Yang-Feng TL, Liao YC et al.. Tyrosine kinase receptor with extensive homology to EGF receptor shares chromosomal location with neu oncogene. Science 1985;230:11321139.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Akiyama T, Sudo C, Ogawara H et al.. The product of the human c-erbB-2 gene: a 185-kilodalton glycoprotein with tyrosine kinase activity. Science 1986;232:16441646.

  • 33.

    Muller WJ, Sinn E, Pattengale PK et al.. Single-step induction of mammary adenocarcinoma in transgenic mice bearing the activated c-neu oncogene. Cell 1988;54:105115.

  • 34.

    Vogel CL, Cobleigh MA, Tripathy D et al.. Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer. J Clin Oncol 2002;20:719726.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Slamon DJ, Leyland-Jones B, Shak S et al.. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001;344:783792.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Romond EH, Perez EA, Bryant J et al.. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 2005;353:16731684.

  • 37.

    Joensuu H, Kellokumpu-Lehtinen PL, Bono P et al.. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med 2006;354:809820.

  • 38.

    Piccart-Gebhart MJ, Procter M, Leyland-Jones B et al.. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 2005;353:16591672.

  • 39.

    Slamon DJ, Eiermann W, Robert N et al.. Phase III trial comparing AC-T with AC-TH and with TCH in the adjuvant treatment of HER2 positive early breast cancer patients: first interim efficacy analysis. Presented at the 28th Annual San Antonio Breast Cancer Symposium. December 8–11, 2005; San Antonio, Texas.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Rusnak DW, Lackey K, Affleck K. The effects of the novel, reversible epidermal growth factor receptor/ErbB-2 tyrosine kinase inhibitor, GW572016, on the growth of human normal and tumor-derived cell lines in vitro and in vivo. Mol Cancer Ther 2001;1:8594.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Xia W, Mullin RJ, Keith BR et al.. Anti-tumor activity of GW572016: a dual tyrosine kinase inhibitor blocks EGF activation of EGFR/erbB2 and downstream Erk1/2 and AKT pathways. Oncogene 2002;21:62556263.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Wood ER, Truesdale AT, McDonald OB et al.. A unique structure for epidermal growth factor receptor bound to GW572016 (Lapatinib): relationships among protein conformation, inhibitor off-rate, and receptor activity in tumor cells. Cancer Res 2004;64:66526659.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Zhou H, Kim YS, Peletier A et al.. Effects of the EGFR/HER2 kinase inhibitor GW572016 on EGFR- and HER2-overexpressing breast cancer cell line proliferation, radiosensitization, and resistance. Int J Radiat Oncol Biol Phys 2004;58:344352.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Xia W, Liu LH, Ho P et al.. Truncated ErbB2 receptor (p95ErbB2) is regulated by heregulin through heterodimer formation with ErbB3 yet remains sensitive to the dual EGFR/ErbB2 kinase inhibitor GW572016. Oncogene 2004;23:646653.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Konecny GE, Pegram MD, Venkatesan N et al.. Activity of the dual kinase inhibitor lapatinib (GW572016) against HER-2-overexpressing and trastuzumab-treated breast cancer cells. Cancer Res 2006;66:16301639.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Kim TE, Murren JR. Lapatinib ditosylate GlaxoSmithKline. Drugs 2003;6:886893.

  • 47.

    Bence AK, Anderson EB, Halepota MA et al.. Phase I pharmacokinetic studies evaluating single and multiple doses of oral GW572016, a dual EGFR-ErbB2 inhibitor, in healthy subjects. Invest New Drugs 2005;23:3949.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Versola MJ, Burris HA III, Jones S et al.. Clinical activity of GW572016 in EGF10003 in patients with solid tumors [abstract]. J Clin Oncol 2004;22(suppl 1): Abstract 3047.

  • 49.

    Burris HA III, Hurwitz HI, Dees EC et al.. Phase I safety, pharmacokinetics, and clinical activity study of lapatinib (GW572016), a reversible dual inhibitor of epidermal growth factor receptor tyrosine kinases, in heavily pretreated patients with metastatic carcinomas. J Clin Oncol 2005;23:53055313.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Blackwell K, Kaplan EH, Franco SX et al.. A phase II, open-label, multicenter study of GW572016 in patients with trastuzumab-refractory metastatic breast cancer [abstract]. J Clin Oncol 2004;22(suppl 1): Abstract 3006.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Blackwell K, Burstein HJ, Pegram M et al.. Determining relevant biomarkers from tissue and serum that may predict response to single agent lapatinib in trastuzumab-refractory metastatic breast cancer [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 3004.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Gomez HL, Chavez MA, Doval DC et al.. A phase II, randomized trial using the small molecule tyrosine kinase inhibitor lapatinib as a first-line treatment in patients with FISH-positive advanced or metastatic breast cancer [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 3046.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Spector NL, Blackwell K, Hurley J et al.. EGF103009, a phase II trial of lapatinib monotherapy in patients with relapsed/refractory inflammatory breast cancer (IBC): clinical activity and biologic predictors of response [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract 502.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Nagata Y, Lan KH, Zhou X et al.. PTEN activation contributes to tumor inhibition by trastuzumab, and loss of PTEN predicts trastuzumab resistance in patients. Cancer Cell 2004;6:117127.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Gomez HL, Doval DC, Chavez MA et al.. Biomarker results from a phase II randomized study of lapatinib as first-line treatment for patients with ErbB2 FISH-amplified advanced or metastatic breast cancer. Presented at the 28th Annual San Antonio Breast Cancer Symposium; December 8–11, 2005; San Antonio, Texas. Abstract 1071.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Lin NU, Carey LA, Liu MC et al.. Phase II trial of lapatinib for brain metastases in patients with HER2+ breast cancer [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract 503.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Bendell JC, Domchek SM, Burstein HJ et al.. Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer 2003;97:29722977.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Lin NU, Bellon JR, Winer EP. CNS metastases in breast cancer. J Clin Oncol 2004;22:36083617.

  • 59.

    Pestalozzi BC, Brignoli S. Trastuzumab in CSF. J Clin Oncol 2000;18:23492351.

  • 60.

    Keefe DL. Trastuzumab-associated cardiotoxicity. Cancer 2002;95:15921600.

  • 61.

    Tan-Chiu E, Yothers G, Romond E et al.. Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. J Clin Oncol 2005;23:78117819.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 62.

    Perez EA, Byrne JA, HAmmond IW et al.. Results of an analysis of cardiac function in 2,812 patients treated with lapatinib [abstract]. J Clin Oncol 2006;24(suppl 1): Abstract 583.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 63.

    Geyer CE, Forster J, Lindquist D et al.. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med 2006;355:27332743.

  • 64.

    Stemmler HJ, Kahlert S, Siekiera W et al.. Prolonged survival of patients receiving trastuzumab beyond disease progression for HER2 overexpressing metastatic breast cancer (MBC). Onkologie 2005;28:582586.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 65.

    Jones SF, Hainsworth JD, Spigel DR et al.. A phase I study of the dual kinase inhibitor GW572016 in combination with paclitaxel (EGF10009) [abstract]. J Clin Oncol 2004;22(suppl 1): Abstract 2083.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 66.

    Chu Q, Goldstein L, Murray N et al.. A phase I, open-label study of the safety, tolerability and pharmacokinetics of lapatinib (GW572016) in combination with letrozole in cancer patients [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 3001.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 67.

    Storniolo AM, Burris HA III, Pegram M et al.. A phase I, open-label study of lapatinib (GW572016) plus trastuzumab: a clinically active regimen [abstract]. J Clin Oncol 2005;23(suppl 1): Abstract 559.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 68.

    Chu I, Blackwell K, Chen S et al.. The dual ErbB1/ErbB2 inhibitor, lapatinib (GW572016), cooperates with tamoxifen to inhibit both cell proliferation- and estrogen-dependent gene expression in antiestrogen-resistant breast cancer. Cancer Res 2005;65:1825.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 69.

    Osborne CK, Shou J, Massarweh S et al.. Crosstalk between estrogen receptor and growth factor receptor pathways as a cause for endocrine therapy resistance in breast cancer. Clin Cancer Res 2005;11:865s870s.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 70.

    Ellis MJ, Coop A, Singh B et al.. Letrozole is more effective neoadjuvant endocrine therapy than tamoxifen for ErbB-1- and/or ErbB-2-positive, estrogen receptor-positive primary breast cancer: evidence from a phase III randomized trial. J Clin Oncol 2001;19:38083816.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 71.

    De Laurentiis M, Arpino G, Massarelli E et al.. A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer. Clin Cancer Res 2005;11:47414748.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 72.

    Xia W, Gerard CM, Liu L et al.. Combining lapatinib (GW572016), a small molecule inhibitor of ErbB1 and ErbB2 tyrosine kinases, with therapeutic anti-ErbB2 antibodies enhances apoptosis of ErbB2-overexpressing breast cancer cells. Oncogene 2005;24:62136221.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 73.

    Carlson RW, Anderson BO, Burstein HJ et al.. The NCCN Breast Cancer Guidelines, version 1, 2007. Available at: www.nccn.org.

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