A trial looking at lapatinib for people with bladder cancer that has spread (LaMB)

Cancer type:

Bladder cancer
Transitional cell cancer




Phase 2/3

This trial looked at lapatinib for advanced bladder cancer. It was for people:

  • with transitional cell cancer (TCC) of the lining of the urinary system (urothelium Open a glossary item)
  • whose cancer had large amounts of 2 proteins called HER1 or HER2 Open a glossary item

Cancer Research UK supported this trial. 

More about this trial

Chemotherapy is the usual treatment for bladder cancer that has spread elsewhere in the body (advanced bladder cancer). Researchers are looking at ways to stop or delay the cancer growth after chemotherapy finishes. In this trial, they looked at a drug called lapatinib (Tyverb).

Lapatinib is a type of targeted cancer drug (or biological therapy Open a glossary item) called a tyrosine kinase inhibitor. Tyrosine kinases are proteins that stimulate cancer cells to grow. Lapatinib blocks the HER1 (also known as epidermal growth factor receptor or EGFR) and HER2 proteins. This stops the signals that cancer cells use to divide and grow. 
Doctors hoped that giving lapatinib after initial chemotherapy might delay or stop cancer growth. But they weren’t sure so wanted to find out more. 

In this trial, some people had lapatinib after chemotherapy and some had a dummy drug (placebo Open a glossary item).

The aim of this trial were to:

  • find out how well lapatinib worked
  • learn more about the side effects 

Summary of results

The trial team found having lapatinib after chemotherapy wasn’t a useful treatment for advanced bladder cancer that has large amounts of HER1 or HER2. 

446 people who had between 4 and 8 cycles of chemotherapy for urothelial bladder were screened to see if they were suitable to join the trial. The researchers tested a sample of their tissue (biopsy Open a glossary item) taken previously to check if their cancer tested positive for HER1 or HER2. 

232 people tested positive for these proteins and fitted the other entry conditions Open a glossary item for the trial. They joined the trial and were put into 1 of the following 2 treatment groups at random Open a glossary item:

  • 116 had lapatinib
  • 116 had a dummy drug

Neither the people taking part nor the doctor knew which treatment they were having. This is called a double blind trial. 

Everyone had treatment for as long as it worked and the side effects weren’t too bad.

The researchers compared the treatments. They looked at how long people lived:

  • before the cancer started to grow again (progression free survival)
  • after treatment (overall survival) 

They didn’t find a significant difference in either of these.

The researchers looked in more detail at people’s HER status. Even those who tested strongly positive for HER1 and HER2 showed no benefit. 

The number of people who had to stop treatment due to bad side effects was similar in both treatment groups. People who had lapatinib had more serious problems that included:

  • diarrhoea
  • tiredness (fatigue)
  • skin rash
  • feeling or being sick 

The researchers concluded that having lapatinib after chemotherapy for advanced bladder cancer wasn’t a useful treatment. They say that further works need to be done to find out more about the role of HER1 and HER2 in advanced bladder cancer. 

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Prof Thomas Powles

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
GlaxoSmithKline (GSK)
NIHR Clinical Research Network: Cancer
Queen Mary University of London

Other information

This is Cancer Research UK trial number CRUKE/09/002.

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Over 60,000 cancer patients enrolled on clinical trials in the UK last year.

Last reviewed:

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