Does Tykerb have a good response?

The combination of Tykerb plus capecitabine (T+C) has a better response than capecitabine alone. Trials that investigated the endpoint “Time to Progression” (TTP) – defined as the time to tumor progression or death from breast cancer from enrollment in the trial, reported a significant difference for those women assigned T+C compared with those assigned capecitabine alone. The number of TTP events was 82 to 121 for women assigned T+C compared to 102 to 126 for those assigned capecitabine alone. Response rates ranged from 23.7% to 31.8% in those given T + C compared to 13.9 to 17.4% given capecitabine alone.

This result was significant enough to stop further enrolment in the trial after 4 months, unblind the trial, and transfer those women receiving capecitabine alone to treatment with Tykerb plus capecitabine. These women were then followed for another 2 years and with the median overall survival reported as 75 weeks in the Tykerb plus capecitabine group compared with 65.9 weeks in those women who originally only received capecitabine. After 2 years, 76% had died in the Tykerb plus capecitabine group compared with 82% in the capecitabine group alone.

Tykerb is recommended to be used in combination with:

• capecitabine for advanced or metastatic HER2 positive breast cancer who have already received prior therapy including an anthracycline, a taxane, and trastuzumab, but whose cancer has still progressed,
• letrozole for postmenopausal women with HER2-positive metastatic breast cancer for whom hormonal therapy is indicated.