Dr. Ahmed on the Impact of Neratinib on CNS Metastases in HER2+ Breast Cancer

Kamran A. Ahmed, MD, an assistant member in the Department of Radiation Oncology and the Department of Immunology at Moffitt Cancer Center, and an assistant professor in the Department of Oncologic Sciences at the University of South Florida, discusses the impact of neratinib (Nerlynx) on patients with central nervous system (CNS) metastases and HER2-positive breast cancer.

The phase 3 NALA trial demonstrated a 24% reduction in the risk of disease progression or death with the combination of neratinib and capecitabine (Xeloda) compared with lapatinib (Tykerb) plus capecitabine in patients with advanced or metastatic HER2-positive breast cancer who had received 2 or more prior anti­­–HER2-based regimens in the metastatic setting.

Moreover, at 54 months, the cumulative incidence for intervention for CNS metastases was 22.8% versus 29.2% for neratinib and lapatinib, respectively, explains Ahmed.

Regarding safety, neratinib was associated with a greater incidence of grade 3 diarrhea compared with lapatinib, at 24% and 13%, respectively, Ahmed says.

Ultimately, these findings served as the basis for the FDA approval of neratinib plus capecitabine in this patient population, concludes Ahmed.