Brain mets shink in new drug combination by at least 50% at the Dana-Farber Cancer Institute.

nancy-lin.jpgDecember 17, 2007
Drug combination shrinks breast cancer metastases in brain

 Nancy Lin, MD

A combination of a “targeted” therapy and chemotherapy shrank metastatic brain tumors by at least 50 percent in one-fifth of patients with aggressive HER2-positive breast cancer, according to data presented by Dana-Farber Cancer Institute investigators at the San Antonio Breast Cancer Symposium.

Lapatinib (Tykerb) and capecitabine (Xeloda) were paired in an extension of a Phase 2 clinical trial in which lapatinib given alone shrank brain metastases significantly in six percent of 241 patients.

In the extension trial, capecitabine was added to lapatinib in 49 patients whose metastases — cancerous colonies in the brain spread from their primary cancer — had progressed while on treatment. With the combination therapy, brain metastases shrank by 20 percent or more in 18 patients (37 percent) and shrank by at least 50 percent in 10 patients (20 percent), reported Nancy Lin, MD, of Dana-Farber’s Breast Oncology Center.

“Very few medications have shown activity in the treatment of brain metastases, particularly in HER-2-positive metastatic breast cancer patients,” said Lin, who led the study with Eric Winer, MD, director of the Dana-Farber Breast Oncology Center. “Therefore, these data are quite encouraging, and further studies are warranted.”

Lapatinib is an oral small-molecule drug from GlaxoSmithKline that is approved along with capecitabine for treating patients with advanced or metastatic breast cancer whose tumors are driven by the abnormal growth signal, HER-2, and who have already undergone therapy including trastuzumab (Herceptin), a taxane drug, and an anthracycline compound. Lapatinib, like trastuzumab, blocks the HER-2 signal.

Up to one-third of women with advanced, HER-2-positive breast cancer may develop metastases to the brain. “Although radiation treatment is often effective, as women live longer with metastatic cancer, some develop worsening of brain metastases despite radiation,” said Lin. “Because cancer in the brain can have a major impact on quality of life, it is important to have treatment options to address this problem.”

The study was sponsored in part by GlaxoSmithKline.

Dana-Farber Cancer Institute ( is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

Media contacts

Bill Schaller
Richard Saltus
(617) 632-4090

About the reseacher  
Nancy U. Lin, MD
Instructor in Medicine, Harvard Medical School
Contact Information
Nancy U. Lin, MD
44 Binney Street
Boston, MA 02115
Office phone: (617) 632-5269
Appointment phone: (617) 632-2175
Fax: (617) 632-1930
Preferred contact method: office phone
Dr. Lin received her MD from Harvard Medical School in 1999. She completed her residency in internal medicine at Brigham and Women’s Hospital and went on to complete fellowships in medical oncology and hematology at Dana-Farber. In 2005, she joined the staff of Brigham and Women’s and Dana-Farber, where she is a medical oncologist and clinical investigator in the Breast Oncology Center.
Board Certification
Internal Medicine, 2002
Hematology, 2005
Medical Oncology, 2005
Brigham and Women’s Hospital, Internal Medicine
Dana-Farber/Partners Cancer Care, Hematology & Oncology
Medical School
Harvard Medical School, 1999


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Lucy in the sky with diamonds , CT Scans & The Beatles.


As a direct result of The Beatles’ success, Dr Timmis claimed, the scanner’s inventor, Sir Godfrey Hounsfield, was able to devote about four years developing the scanner from its 1968 prototype, to something that could be used in a clinical setting. His work was done in the Central Research Laboratory, a facility near Heathrow airport that was part of the EMI Group. Having sold 200 million of the Fab Four’s singles, (at seven inches, almost enough vinyl to stretch the length of the equator) the Beatles’ record company, EMI, was able to fund Hounsfield to do his research and the CT scanner was ready be used in hospitals in the 1970’s.

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Daily review question IV

In a 3d acquisition, the slices are produced by:

a)A phase encoding gradient applied in the slice direction.

b)Multiple 180* pulses along the slice selection direction.

c)Sampling multiple lines of K-space per pulse sequence repition.

d)Very accurate RF pulses.