It was tested with capecitabine (Xeloda) vs Xeloda alone and seems to target brain
mets
there are less toxicifying ways, to the whole body, to address brain mets - RT
J
<http://www.cancer.gov/ncicancerbulletin/NCI_Cancer_Bulletin_060606/page2>
The phase III study randomly assigned 160 women to receive lapatinib plus
capecitabine and 161 women to receive capecitabine alone. All of the women had
advanced or metastatic breast cancer that had recurred or progressed following
prior therapy with an anthracycline drug, a taxane, and trastuzumab.

"The inhibition of lapatinib's second target, EGFR, may not benefit women with
breast cancer but could make the drug useful against other cancers, said Dr. Julie
Gralow of the University of Washington, who commented on the study at ASCO."
<quote>

http://www.newsday.com/news/health/ny-hscanc145129875mar14,0,3565299.story?coll=
ny-health-print

FDA OKs drug for aggressive breast cancer
March 14, 2007
Evidence suggests that Tykerb can breach the blood-brain barrier, the protective
sheath that keeps most substances out of the brain.

Thus the new drug is more likely to reach cancers that have metastasized to the
brain.<end quote>

Seems to me they should have tested vs Herceptin?

http://www.chron.com/disp/story.mpl/nation/4583937.html
Funding seems to affect breast cancer drug trial results
Peppercorn's team looked at 140 breast cancer studies published in 1993, 1998 or
2003 in leading medical journals. Among all 140 published studies analyzed,
researchers found that 78 percent of industry-sponsored studies reported favorable
results, while just 66 percent of non-industry studies were positive.

Peppercorn said there are many possible explanations for the discrepancy. For one,
he said, drug companies may be less inclined to publish when studies are negative.
Or it could be that pharmaceutical companies are "flat out better" at identifying
medicines most likely to perform well in clinical trials, Peppercorn said.

A new national clinical trials registry, administered by the federal government,
will track results from all registered trials, published or not.

That data will eventually make it easier to know whether industry-backed trials
actually produce better results, or whether drug companies are burying their bad
results by not publishing,

Less good research?
"We know how to do clinical trials," said Alan Goldhammer, deputy vice president
of regulatory affairs for PhARMA. "A lot of drugs that are not going to be
successful are never brought into the clinic. Of course we're going to be more
likely to publish favorable results."

Jerome Reichman, a professor at Duke University Law School and critic of the
pharmaceutical industry's growing role in clinical trials, said he doesn't accept
the industry explanation. He notes that pharmaceutical companies often justify
high drug prices by saying they have to cover the costs of testing drugs that
flop.

Reichman said having the drug companies behind clinical trials means there will be
less good research comparing how well new products do against existing drugs.

"They will never ask the question, 'Is there another drug that will do just as
good or better at a cheaper price?' — they have no incentive," said Reichman, who
co-wrote a recent paper that argues for public funding and oversight of clinical
trials. It was published in the January issue of the journal Economist's
Voice<quote>

----------------
It's all over the place, but here are two to start with:

http://www.cbsnews.com/stories/2007/03/13/health/main2564600.shtml

http://www.nytimes.com/2007/03/14/business/14drugs.html?_r=1&oref=slogin

Eva

-----------------
I agree with you, but I think doctors will start prescribing it "off-label"
to Stage III patients and those not taking Xeloda.  It's just a matter of
time.  They initially only approved Herceptin for Stage IV patients but I
was Stage III and I was given it.  (This is the one good thing about the
profit-driven US health care system.  If I lived in Canada or the UK I
probably would not have gotten Herceptin and I wouldn't be talking to you
now.)

Eva

Firstly it is a new drug and knowledge of the side effects is limited,
so the tendency is at this stage only to give it to patients who have
little to lose.  Of those patients who's metastatic cancer failed to
respond to chemotherapy and Herceptin, about half responded to
lapatinib.  It is not known how effective it would be for other parts of
the population.

Secondly these drugs are very expensive, and for health insurers to pay
for them for a wide range of patients inevitably means that they have
less to pay for other treatments for other patients, or else the overall
cost of insurance goes up.  In the UK some hospitals are having to close
beds and cut operation lists in other areas in order to fund the NHS
requirement to give Herceptin to cancer patients, for example.

Of course that does not affect those who would pay for their drugs
privately, but relatively few can afford that.

There is a worldwide phase III clinical trial by GSK currently
recruiting called TEACH that is investigating its possible use as an
adjuvant therapy.
http://clinicaltrials.gov/ct/show/NCT00374322

Tim Jackson

Because it really doesn't make any difference, Bea - if it's effective
in early stages it'll be effective in later stages.  If it works, it
works - and at almost $3000 a month Tykerb probably isn't something to
give to the masses.

hugs -

allan