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Breast Cancer and Biological Therapy

Biological therapy uses the body's own immune system (its antibodies) to fight breast cancer cells, while leaving healthy cells unaffected. 

One such antibody is Herceptin, a monoclonal (meaning single) antibody. An antibody is a protein made by the body's own immune system. But Herceptin can work only if the woman carries the HER2 gene in those tumor cells. About 25% of breast cancer patients carry this gene and are considered HER2 positive. 

Recommended Related to Breast Cancer

About This PDQ Summary

Purpose of This Summary This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of male breast cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. Reviewers and Updates This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial...

Read the About This PDQ Summary article > >

Herceptin is the first-line treatment of HER2-positive metastatic breast cancer in combination with chemotherapy drugs. Herceptin may also be used alone, indefinitely for HER2- positive metastatic breast cancer.

Perjeta (pertuzumab) is another monoclonal antibody approved for treatment of HER2-positive metastatic breast cancer. It is approved for use in combination with Herceptin and the chemotherapy Taxotere. 

Another drug of this type is Tykerb. It works in HER2-positive patients when Herceptin is no longer effective. It is used in combination with Xeloda, Femara, or Herceptin. Kadcyla is a drug used in patients who have metastatic disease and have already taken Herceptin and a class of chemotherapy drugs called taxanes, which are commonly used to treat breast cancer.  These drugs may have been used together or separately. 

For HER2-negative, advanced breast cancer, the drug Afinitor is taken along with the drug exemestane in postmenopausal women who have already tried other treatments. Afinitor blocks the effects of an 
enzyme needed for cancer growth in women with hormone-receptor positive cancer. 

Other types of antibodies are being researched to fight cancer and include:

  • Angiogenesis inhibitors. These antibodies prevent the growth of new blood vessels, cutting off the supply of oxygen and nutrients to cancer cells. However, the only such drug used for breast cancer, bevacizumab, lost its FDA approval for breast cancer because the drug's risks outweighed its benefits and it didn't improve the overall survival of breast cancer patients.
  • Signal transduction inhibitors. These antibodies block signals inside the cancer cell that helps the cells divide, stopping the cancer from growing. They are currently being studied to see if they're effective.

Before treatment begins, print out these Questions to Ask to help you better understand your care.

Also see, Follow-Up Care After Your Treatment.

Side Effects of Biological Therapy for Breast Cancer

When biological therapy is used to treat breast cancer, side effects can include:

  • Allergic reactions
  • Difficulty breathing
  • Swelling
  • Nausea
  • Fever and chills
  • Dizziness or weakness

Talk to your doctor about the possible side effects to watch for and what you should do if they occur. The FDA has warned that the treatment with Perjeta may be harmful or fatal to a fetus. Women who are pregnant should not take Perjeta. 

Recognizing a Breast Cancer Emergency

If you develop fever and chills, notify your doctor immediately or go to the emergency room. Other symptoms to tell your health care provider about include: 

  • New mouth sores, patches, swollen tongue, or bleeding gums.
  • Dry, burning, scratchy, or "swollen" throat.
  • Cough that is new or persistent and produces mucus.
  • Changes in bladder function, including increased frequency or urgency to go; burning during urination; or blood in your urine.
  • Changes in gastrointestinal function, including heartburn; nausea, vomiting, constipation, or diarrhea that lasts longer than two or three days; or blood in stools.

 

WebMD Medical Reference

Reviewed by Arnold Wax, MD on May 07, 2012
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