For several years, the drug Herceptin has been used to
treat women with HER2-positive breast cancer that has metastasized or
recurred. It's a kind of drug known as a monoclonal antibody. It works
like a heat-seeking missile, homing in on cells that make too much
HER2neu protein. Used either with chemotherapy or alone, Herceptin can
reduce tumor size and increase a woman's chances of both overall
survival and disease-free survival.
But
the trials that led to Herceptin's FDA approval were all in women with
advanced breast cancer. Would Herceptin work as well in women with
early-stage disease? Within the last year, promising research has
indicates the answer may be yes.
In a study released
last June, scientists at the University of Texas M.D. Anderson Cancer
Center in Houston looked at women with early-stage, HER2-positive breast
disease. They found that more than twice as many women who received
Herceptin as part of their presurgical chemotherapy had their tumors
completely disappear compared with women who received chemotherapy
alone. Indeed, the results were so striking that the researchers stopped
the study early, after enrolling only 42 of a planned 164 patients.
"More
than 65% of the Herceptin patients had a complete response rate, as
compared with only 26% of patients who received chemotherapy only," says
Aman Buzdar, MD, deputy chair of the department of breast and medical
oncology at the M.D. Anderson Cancer Center.
So why
hasn't Herceptin been approved for use in early-stage HER2-positive
breast cancer yet? First, because of the relatively small size of the
trial, and second, because of concerns about its side effects. In a
small percentage of patients, Herceptin can cause heart damage and
sometimes even heart failure.
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