Stomach cancer is known to have amplification of the ErbB2 (HER2) gene and responds to the drug Herceptin, which used this pathwayto attach cacner cells . Recently, there has been an interest in using Tyker(lapatinib) which is a drug that utalizes the same mechanism of action as Herceptin. One such trial is: LOGiC – Lapatinib Optimization Study in ErbB2 (HER2) Positive Gastric Cancer: A Phase III Global, Blinded Study Designed to Evaluate Clinical Endpoints and Safety of Chemotherapy Plus Lapatinib. This is an international multi-center trial for patients stomach, esophagus, or gastro-esophageal junction cancer with amplification of the ErbB2 (HER2) gene. The triallooks at whether lapatinib, when added to the chemotherapy regimen, capecitabine extends the time to progression and overall life. Chemothrapy is administered to all patients, who then randomly get either lapatinib or placebo. There is evidence of effectiveness for braa metastaes, at least in breast cancer(Lin et al).
Iqbal et al showed that Tykerb is an effective first line drug. The evidence thus far suggests that the combination of lapatinib + capecitabine shows promising efficacy and is well tolerated. The same appears to be true of Taxol and lapatinib and studies of this combination are ongoing.
A number of issues remain to study: how to combine Tykerb with toehr drugs, the role of Taykeb in patients previousely treated with Herceptin, and efficacyfor brain metastases.
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