Dec. 15, 2009 (San Antonio) -- In findings that have been eagerly awaited by
women with breast
cancer and their doctors, researchers report that the breast cancer drug Herceptin should be given at the same time as
chemotherapy, not after chemotherapy is concluded.
"Giving the drugs concurrently instead of
sequentially results in an additional 8,000 women with HER2-positive cancer in
the U.S. being alive and without disease each year," Edith Perez, MD, of the
Mayo Clinic tells WebMD.
About 20% of breast cancer patients have HER2-positive cancers -- tumors
that have too much of a type of the HER2 protein. Herceptin binds to and blocks
HER2 receptors that appear on the surface of some breast cancer cells.
Compared with chemo alone, giving Herceptin after chemo cuts the chance that
cancer will come back within five years by about one-third, Perez says.
Giving Herceptin and chemo together slashes the risk of recurrence by an
additional one-fourth, she says. "It's a huge gain."
Both the concurrent and sequential methods of giving the drugs are approved
by the FDA, and most U.S. doctors already give the drugs together, says
Claudine Isaacs, MD, a breast cancer specialist at the Georgetown Lombardi
Comprehensive Cancer Center in Washington, D.C.
But in Europe and elsewhere, doctors tend to give Herceptin after
chemotherapy has ended, she says. As a result, the findings have been eagerly
awaited, Isaacs says.
She moderated a news briefing at which the results were presented at the
annual San Antonio Breast Cancer Symposium.
Giving Herceptin, Chemo Together Helps Breast Cancer Patients
The study involved 3,133 women with HER2-positive tumors. They were given
one of three treatments: three chemo drugs alone; three chemo drugs with
Herceptin given at the same time as the third chemo drug; or three chemo drugs
followed by Herceptin.
By five years later, both Herceptin strategies beat out chemo alone in terms
of the number of women who were alive and free of their disease. But women
given Herceptin and chemo together fared the best, Perez says.
The results showed that:
71.9% of women given chemo alone were alive and free of cancer.
80.1% of women given chemo followed by Herceptin were alive and free of
84.2% of women given chemo plus Herceptin started at the same time as the
third chemo drug were alive and free of cancer.
Perez says she believes the drugs act synergistically to improve
Heart problems, a known side
effect of Herceptin, occurred in about 3% of women in either Herceptin group
vs. less than 1% in the chemo-only group.
"But most of these [heart problems] are transient in nature and manageable
with medical therapy," she says. "Cancer recurrence is the big problem you want
The National Cancer Institute, the Breast Cancer Research Foundation, and
Genentech, which makes Herceptin, funded the study.