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Combo May Help Cancer Patients ; Study Says Chemo, Drug Aid Survival

Posted on: Tuesday, 7 March 2006, 15:00 CST

By KAWANZA NEWSON Milwaukee Journal Sentinel

MILWAUKEE -- Administering a short course of the drug Herceptin prior to chemotherapy improves survival among certain women with early-stage breast cancer, a new study suggests.

Still, experts say it's unclear how long the drug should be used to get the optimum benefit. Usually it's administered for a longer period after chemotherapy.

"What's intriguing is that their rates of breast cancer survival were similar to a study that gave Herceptin for a year," said James A. Stewart, an oncologist and professor of medicine at the University of Wisconsin's Comprehensive Cancer Center in Madison who was not involved in this study.

"It's a teaser," he said. "It really makes you wonder how long you need to treat with Herceptin. Do you need a year, two years or less? We really don't know."

Herceptin, known generically as trastuzumab, is a monoclonal antibody, or a type of genetically engineered protein, used to treat an estimated 20 percent of breast cancer cases in which tumors produce too much of a protein known as HER2.

The drug is expensive -- averaging $40,000 to $50,000 a year -- and has been shown to cause heart damage among users, particularly those taking a standard group of chemotherapy drugs known as anthracyclines, which are drugs that are known to also cause heart damage, Stewart said. Typically, Herceptin is given after chemotherapy, which can compound the cardiovascular risk.

"It used to be that surgery was the most expensive part of breast cancer care, but that's not true anymore. Now it's the medicine," he said.

Last fall, three separate studies published in the New England Journal of Medicine found that women who took Herceptin for a year in combination with standard combination chemotherapy had a 52 percent decrease in disease recurrence compared with patients treated with chemotherapy alone. In addition, women who took Herceptin with a specific chemotherapy regimen reduced their risk of death by 33 percent.

The new study, also published in the New England Journal of Medicine, involved more than 1,000 Finnish women with earlystage breast cancer. Of the 232 women with HER2-positive tumors, 116 were randomly assigned to receive nine weeks of Herceptin after surgery, but prior to chemotherapy treatment, which is known to damage the heart.

"The optimal duration of adjuvant (Herceptin) therapy is not known and may be clarified only in further randomized trials," the authors write.

Source: Albuquerque Journal

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