Certain Drug Combinations May Beat Back Aggressive Breast
FRIDAY, Dec. 10 (HealthDay News) -- Combinations of targeted
therapies for an especially aggressive type of breast cancer could
potentially usher the majority of affected patients into remission,
researchers at a major breast cancer meeting said Friday.
Presenting results from three trials at the annual San Antonio
Breast Cancer Symposium, scientists explained that administering
two or more drugs designed to treat HER2-positive tumors resulted
in much higher remission rates than doses of any one drug or
standard chemotherapy alone.
Given to patients several weeks before cancer surgery, with or
without chemotherapy, the medications often shrank tumors
dramatically or eradicated them altogether, the researchers
HER2-positive cancer is receptive to a protein called human
epidermal growth factor receptor 2, which promotes the growth of
malignant cells. Drugs that specifically target HER2 cells --
including Herceptin, Tykerb and pertuzumab -- have been proven
effective on these types of tumors, which tend to be more
aggressive than other breast cancers.
"I think it's a very exciting era, because we've gone from a very lethal era . . . to a point where we might be able to cure this disease," said Dr. Neil Spector, a professor of medicine at Duke University Medical Center, who moderated the symposium session.
Using Tykerb and Herceptin combined with chemotherapy before
surgery, researchers followed 2,500 women with early breast cancer
at 85 facilities throughout Germany. About half of these patients
achieved remission before surgery, said Dr. Michael Untch, head of
the multidisciplinary breast cancer department at Helios Clinic in
"In a majority of these patients, we could do breast-conserving surgery where previously they were candidates for mastectomy," Untch said.
The team will continue following the patients to see if
remission at surgery affects their outcome.
Another study showed the combination of pertuzumab and
Herceptin, when given with the chemotherapy drug docetaxel,
eradicated 46 percent of tumors, 50 percent more than the results
achieved without pertuzumab. Also, 17 percent of tumors were
eradicated by combining the two targeted drugs and skipping
chemotherapy, the researchers said.
"Our study is the only one that has tested the hypothesis that [pertuzumab and Herceptin] could work without chemotherapy in these women," said lead researcher Dr. Luca Gianni, director of medical oncology at the Fondazione IRCCS Istituto Nationale Tumori Fondazione IRCCS Istituto di Milano in Italy.
The third study, which included 455 patients followed at 99
sites for nearly two years, indicated that a combination of Tykerb,
Herceptin and the chemotherapy drug Taxol improved tumor response
rates significantly more than any of the drugs alone.
The mix led to a 51 percent remission rate, compared to 29
percent for a single therapy, said lead researcher Dr. Jose
Baselga, chief of the division of hematology and oncology and
associate director of the Massachusetts General Hospital Cancer
"With these new therapies, we could easily go to curing over 90 percent of these patients, which is remarkable since this was the most lethal kind of breast cancer 10 years ago," said Baselga.
"This is a very fast advancement of new therapies," Untch agreed.
Researchers countered negative side effects of the drugs, which
included diarrhea, liver function abnormalities, skin disorders and
a low white blood cell count, by lowering patients' dosages or
administering additional medications to alleviate specific
Describing targeted therapies as a "HER2 blockade," Spector said
if cost was not an issue, he would use all three drugs on
HER2-positive breast cancer patients.
Discussing the high cost of treatment at the session, the
researchers noted that spending more money on faster-acting, more
effective treatments could save other treatment expenditures down
"I do think we need to be creative in the ways we [run through] this data to make things more affordable," Spector said.
Because this study was presented at a medical meeting, the
findings should be viewed as preliminary until they are published
in a peer-reviewed journal.
To learn more about surgical options for breast cancer,
visit the American Cancer Society.
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