October 20, 2005
'Herceptin' Hailed as Major Advance in Treating Aggressive Breast CancerTopics: Medicine
It's a little early for the word "cure," but from the early returns, it's looking like we might be getting closer to it. Herceptin is already used to treat certain advanced breast cancers, but according to three studies published today involving 5,000 women, it apparently also works against an aggressive type of early breast cancer.
(...)Some doctors are hailing the findings as a major advance in treating breast cancer -- the second-most-deadly cancer in US women, behind lung cancer -- although results apply to only a small subset of patients.
(...) "Clearly, the results ... are not evolutionary but revolutionary," Gabriel Hortobagyi, director of the breast cancer program at Houston's MD Anderson Cancer Center, writes in an editorial that accompanies the studies in The New England Journal of Medicine. Herceptin targets a gene called HER2, which causes an overproduction of a particular protein in about 20% of invasive breast tumors. HER2-positive tumors are more likely to have spread to nearby lymph nodes and less likely to have receptors for the hormones estrogen and progesterone -- both characteristics that are linked to a greater risk of recurrence and death.
,blockquote>(...) The new studies found that women with early, HER2-positive breast cancers who received Herceptin and conventional chemotherapy were half as likely to have a recurrence as women with similar tumors who received only chemotherapy. "On the basis of these results, our care of patients with HER2-positive breast cancer must change today," Hortobagyi writes.Good as the news sounds, it doesn't come without risk. Clinical trials in women with advanced disease found that those who received Herceptin and chemotherapy had as much as a 16% risk of developing congestive heart failure, which can be fatal. Herceptin administration can result in the development of both ventricular dysfunction and congestive heart failure, and the risk is significant enough such that discontinuation of Herceptin treatment should be strongly considered in patients who develop a clinically significant decrease in left ventricular function. The incidence and severity of cardiac dysfunction was particularly high in patients who received Herceptin in combination with anthracyclines and cyclophosphamide.
Posted by Richard at October 20, 2005 8:07 PM
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