New Ways to Treat Breast Cancer
A new generation of drugs and treatment options gives patients new hope in the fight against breast cancer.
In the not so distant past, a diagnosis of breast cancer frequently yielded a standard prescription: tumor removal via mastectomy or sometimes lumpectomy, usually followed by radiation and sometimes chemotherapy.
While the approach clearly worked for some women, it didn't work for all -- leaving doctors puzzled.
"It was difficult to understand why some women thrived after breast cancercancer treatment while others perished," says Julia Smith, MD, director of the Lynne Cohen Breast Cancer Preventive Care Program at the NYU Cancer Institute in New York City.
The reason became increasingly clear, say experts, when they stopped looking at why a woman wasn't responding to treatment, and instead examined why the cancer didn't respond.
What they discovered: The concept of tumor biology. In short, not all breast tumors are alike -- or respond to the same treatment.
"We realized breast cancer isn't just one disease -- it's at least three different diseases, each requiring a different treatment approach," says Cliff Hudis, MD, chief of breast cancer medicine service at Memorial Sloan-Kettering Cancer Center in New York City.
These differences have now morphed into a full-fledged treatment approach: target-specific drugs aimed not just at killing cancer cells, but in some instances, disrupting and dismantling the entire tumor-creating mechanism. Usually paired with more traditional treatments such as lumpectomy -- and sometimes radiation -- these new treatments are helping to ensure that even the most stubborn cancers now have a chance to be cured.
Targeting Breast Cancers
Among those benefiting most from this approach are women with tumors identified as HER2 positive.
Affecting one in every three women who develop breast cancer, Smith says HER2-positive tumors occur when a genetic glitch causes an overproduction of the HER2 protein. This protein promotes the growth of cancer cells.
"This is a very aggressive cancer and there was little we could offer in terms of treatment," says Smith.
The target-specific drug that changed all that is Herceptin -- a treatment that attaches itself to the cancer-promoting proteins and slows or shuts down production.
Hudis tells WebMD that Herceptin not only increases survival rates but also reduces the likelihood of tumor recurrence.
"Now we can not only offer treatment for something that was untreatable before, we can also help prevent what once was an incurable disease," says Hudis.
Herceptin is FDA approved for metastatic breast cancer that is positive for HER2. However, a number of clinical trials conducted in 2005 revealed that when combined with chemotherapy, Herceptin is similarly effective in treating early-stage HER2-positive breast cancer.
For those who can't take Herceptin, (there is, for example, some evidence it may cause cardiovascular problems in some users), the experimental drug Tykerb may help. Although it works in a slightly different manner, experts say it accomplishes similar results -- and may have treatment advantages of its own.
Although still in clinical trials, Hudis says results are impressive and may facilitate a fast track to FDA approval.