Herceptin® and Chemotherapy in HER2-Positive Breast Cancer
Herceptin® and Chemotherapy in HER2-Positive Breast Cancer
Source: New England Journal of Medicine - October 20, 2005
Background on study
October 28, 2005 - Herceptin® (trastuzumab) has been used for many years to treat metastatic breast cancer. New data have now been released showing that Herceptin® can be a very successful treatment for early breast cancer as well.
Herceptin® is a specially made antibody that targets cancer cells that have high numbers of a protein called HER2/neu (human epidermal growth factor receptor 2) on their surface. When attached to the HER2/neu protein, Herceptin® slows or stops the growth of the cancer cells.
Two recent clinical trials found that chemotherapy plus Herceptin® cut the chance of cancer recurrence in half compared to chemotherapy alone.
About 20 to 25 percent of breast cancer patients are HER2/neu positive, meaning their breast cancer cells express high numbers of HER2/neu on their surface and are potentially eligible for treatment with Herceptin®. The HER2/neu status of a tumor is determined by testing tissue removed during biopsy.
One major risk linked to the use of Herceptin® is congestive heart failure, a serious heart condition. In the two newly released trials, three to four percent of patients treated with chemotherapy plus Herceptin® experienced heart failure, compared to less than one percent of those treated with chemotherapy alone. Because of this risk, Herceptin® plus chemotherapy is generally recommended only for patients with lymph node-positive cancer or node-negative cancer with tumors over 1 cm in size.
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Komen Foundation comments
This news, which was originally reported last May at the American Society of Clinical Oncologists (ASCO) meeting, is very exciting. It has the potential to change the way doctors treat women with breast cancer who are HER2/neu positive.
Having a HER2/neu positive tumor is associated with a higher risk breast cancer recurrence and death. This news has the potential to change what was until now a poor prognosis, to a better or good prognosis.
Herceptin® does have side effects, such as possible congestive heart failure, that we need to be aware of. Physicians have to assess a patient's cardiac status to make sure they are good candidates for Herceptin® use.
It's important to note that the results just released are from only a few years of follow-up. We will want to monitor the long-term survival benefits of patients taking Herceptin®.
Does using Herceptin® amount to a cure for breast cancer? We hope so, for the 20 to 30 percent of breast cancer patients who over-express HER2/neu, but we really don't know yet. The women have only been followed for a few years.
This news is one example of the promise of targeted therapies. We are funding research looking for other targets like HER2/neu so that drugs can be developed specifically for those targets.
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