July 15, 2005

Drug combo ups breast cancer survival-study

NEW YORK (Reuters Health) - The combination of the
anti-cancer drugs Herceptin and Taxotere appears to work better
than Taxotere alone in women with advanced breast cancer that
has spread beyond the breast, research shows. Moreover, there
is little added toxicity when Herceptin is given.

Herceptin (trastuzumab) is a monoclonal antibody, meaning
that it binds to one specific protein, HER2, which helps
regulate cell growth. Overexpression of HER2, a sign of more
aggressive cancer, occurs in about 25 percent to 30 percent of
breast tumors. Taxotere (docetaxel) is a chemotherapy drug
widely used to treat breast cancer and other cancers as well.

Previous studies indicate "synergy" between the two agents
in women with breast cancer. To investigate further, Dr. Michel
Marty, from Innovative Therapeutics in Paris, and colleagues
treated 186 women with HER2-positive advanced breast cancer
with six cycles of Taxotere with or without Herceptin.

Women treated with the combination regimen had a higher
response rate (61 percent vs. 34 percent) and survived
significantly longer (31.2 vs. 22.7 months) than women given
Taxotere alone.

These findings, along with previous findings, support the
use of Herceptin with a taxane such as Taxotere as first-line
therapy for HER2-positive advanced breast cancer, the
researchers conclude in the Journal of Clinical Oncology.

Overall, the number and severity of side effects seen in
both groups were similar, aside from a higher incidence of
neutropenia in the combination group. Neutropenia is a
condition characterized by a drop in infection-fighting white
blood cells that can occur with frequent chemotherapy.

Cardiac toxicity with Herceptin and Taxotere combination
therapy, a concern in earlier trials, is "manageable," the
authors conclude, based on the low incidence of heart problems
seen in women in the study.

In a commentary, Drs. Charles L. Vogel and Elizabeth
Tan-Chiu, from the Cancer Research Network in Plantation,
Florida, comment that while they "fully endorse" first-line
Herceptin in these women, "a lingering question" remains
regarding the survival benefit of Herceptin combination therapy
compared with a sequential treatment approach.

SOURCE: Journal of Clinical Oncology, July 1, 2005.