Tykerb

Jordan Barzensky, Hannah Judy, Lauren Kosslow, Allison Pavlan

SBL 247 01
1 May 2019
Novartis. (2019). Mechanism of Action. Novartis Pharmaceutical Corporation. Available from: https://www.hcp.novartis.com/products/tykerb/her2-abc-mbc/mechanism-of-action/
Evidence (Document A)

● Tykerb
○ Targeted drug

○ Attacks specific abnormalities

○ Treatment for advanced cancer

● Limitations
○ Expensive

○ Side effects
Evidence (Document B)
● Detection & treatment
○ Mammograms
○ Chemotherapy
○ Other therapies

● HER2nu gene
○ Less responsive to chemotherapy
○ Risk lowered with Herceptin treatment

● St. John’s Wort

○ Recommended by Dr. Larry Futchy
Evidence (Document C)
Evidence (Document D)
● Tykerb (25.2%)
● Tykerb + St. John’s
Wort (5.86%)
● St. John’s Wort
(2.07%)
● Tykerb +
chemotherapy
(40.8%)
● Chemotherapy
(26.0%)
Evidence (Document E)
Evidence (Document F)
● Chemotherapy cures 1-3% of cancer cases
○ Herceptin is the only significantly beneficial drug

● Dietary compounds interact with molecular targets

○ Green tea polyphenols
○ Turmeric

● Advanced cancer requires multifactorial treatment

○ Multiple treatment options (Document B)
○ Conventional treatment in combination with botanicals
○ St. John’s Wort
Evidence (Document G)
● Treatment of prostate cancer
○ Cabazitaxel > mitoxantrone

● Herbal interactions
○ Harmful effects

● St. John’s Wort

○ Decreased plasma levels of SN-38 by 42%
○ Decreased systemic exposure of imatinib by 32%

● Garlic supplements
○ No statistical significance
Evidence (Document H)
● Founder of St.
John’s Wort
○ Ryan Forbes
● Dr. Larry Futchy
(Document B)
Strengths of Tykerb
● High response percentage when used in combination with chemotherapy (Document
D)
● Tumor size decreased up to 35% with two chemotherapy cycles & Tykerb at a 1250
mg dose (Document E)
● Decreases stress levels in cancer patients (Document C)
● Used when cancer has progressed and is unresponsive to Herceptin (Document A)
Limitations of Tykerb

● Does not work for all EGFR overexpressing breast cancer cells
(Zhang et al., 2015)
● Expensive (Document A)
● Side effects (Document A)
● Does not decrease stress as effectively as other treatments
(Document C)
Recommendations

● St. John’s Wort should no longer be used

● Tykerb should continue being produced

● Tykerb can be used alone or in combination with

chemotherapy
Memo
References
Document A
Document B
Document C
Document D
Document E
Document F
Document G
Document H
Dai, Amit K. Tiwari, C. W., Ashby, C. R., Huang, Y., Robert W. Robey, Y. L., & Suresh V. Ambudkar, Z. C. (2008, October 01). Lapatinib
(Tykerb, GW572016) Reverses Multidrug Resistance in Cancer Cells by Inhibiting the Activity of ATP-Binding Cassette Subfamily B
Member 1 and G Member 2. Retrieved from http://cancerres.aacrjournals.org/content/68/19/7905.short
Fornsaglio, J. (2019). Class notes. Personal Collection of J. Fornsaglio, Seton Hill
University, Greensburg, PA.
Mechanism of action. (2019). Retrieved from https://www.hcp.novartis.com/products/tykerb/her2-abc-mbc/mechanism-of-action/
Rusnak, D. W., Alligood, K. J., Mullin, R. J., Spehar, G. M., Arenas ‐Elliott, C., Martin, A., . . . Gilmer, T. M. (2007, July 16). Assessment of
epidermal growth factor receptor (EGFR, ErbB1) and HER2 (ErbB2) protein expression levels and response to lapatinib (Tykerb®,
GW572016) in an expanded panel of human normal and tumour cell lines. Retrieved from
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2184.2007.00455.x
TEACH: Tykerb Evaluation After Chemotherapy. (2011, August 27). Retrieved from
https://www.sciencedirect.com/science/article/pii/S1526820911707339
Zhang, L., Ngo, J.A., Wetzel, M.D., Marchetti, D. (2015). Heparanase mediates a novel mechanism in lapatinib-resistant brain metastatic breast
cancer. Neoplasia: 17(1); 101-113. doi: 10.1016/j.neo.2014.11.007