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Drug Combo Wipes Out Tumor Cells

Herceptin-Tykerb Combo Helps Before Surgery for Early Breast Cancer
By
WebMD Health News
Reviewed by Laura J. Martin, MD

Dec. 10, 2010 (San Antonio) -- Giving a combination of the targeted drugs Herceptin and Tykerb before breast cancer surgery wipes out  tumor cells in about twice as many women as either drug alone.

Both drugs target a protein called HER2 that is overproduced in about 25% of breast cancers. Herceptin blocks the protein on the surface of the cell and Tykerb works inside the cell.

In the study, about 450 women getting chemotherapy were given Herceptin, Tykerb, or a combination of the two.

Tumor cells were eradicated in 51% of women given both drugs, compared with 30% of those given Herceptin alone and 25% of those given Tykerb alone.

The one-two punch has already been shown to extend the lives of women with advanced breast cancer when given after surgery.

The new approach, which involves giving women with early breast cancer the drugs before surgery, holds the possibility of "enhancing the number of women cured and sparing women from [costly] therapies down the road," said study head Jose Baselga, MD, PhD, chief of the division of hematology and oncology and associate director of the Massachusetts General Hospital Cancer Center in Boston.

The women in the current study haven’t been followed for long enough to prove the combo extends lives. But studies in which Herceptin is given after surgery show that 88% of women with HER2-positive breast cancer are alive and free of cancer five years after treatment, he tells WebMD.

Based on the current findings, you would expect giving the combination of Herceptin and Tykerb before surgery and giving Herceptin after surgery would increase that figure to about 90%, Baselga says.

More Side Effects With Tykerb

Tykerb, both alone and in combination with Herceptin, was associated with a higher rate of serious diarrhea: It affected 23% of women on Tykerb, 21% of women on the combo, and 2% of women on Herceptin alone.

There were also more serious liver function problems with Tykerb: About 13% and 9% of women in the Tykerb alone and combo groups were affected, respectively, vs. 1% in the Herceptin group.

Women taking Tykerb were also more likely to have a low white blood cell count and skin rashes. One woman taking the combination treatment died, but the cause is not yet known, according to Baselga.

The study was funded by GlaxoSmithKline, which makes Tykerb.

The findings were presented at the San Antonio Breast Cancer Symposium.

Herceptin vs. Tykerb Before Breast Cancer Surgery

Also at the meeting, German researchers reported that when given with chemotherapy, Herceptin alone beat out Tykerb alone at eradicating cancer cells in the breast and lymph nodes prior to surgery.

The study involved about 600 women with early and locally advanced cancer.  Tumor cells were wiped out in 31% of women given Herceptin and 22% of those given Tykerb.

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