The gastrointestinal and hepatic lapatinib-associated adverse effects

Lapatinib is oral receptor tyrosine kinase inhibitor, inhibiting both HER2 (ErbB-2) and HER1 (ErbB1) receptors. Its efficacy in the treatment of metastatic and locally advanced breast cancer limited to HER2 overexpressing tumors was confirmed in several phase II and phase III clinical trials. In ongoing trial, activity of lapatinib in combination with chemotherapy ± trastuzumab in adjuvant setting is investigated. Several toxicities are specific to lapatinib. The most common are diarrhea and skin toxicities (rash). Hepatic toxicity are rare but can be life threatening. These side effects may limit prolonged treatment. The aim of this article is to review the incidence and mechanism of gastrointestinal and hepatic lapatinib-associated adverse effects and also provide recommendation how to manage them in clinical practice.