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2 Pre-Surgery Drug Treatments Show Promise Against Aggressive Breast Cancer

In studies, combo regimens produced better results for 'triple-negative' disease
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WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Women fighting an aggressive form of breast cancer may benefit from adding certain drugs to their chemotherapy regimen, and taking them prior to surgery, new research finds.

This pre-surgical drug therapy boosts the likelihood that no cancer cells will be found in breast tissue removed during either mastectomy or lumpectomy, according to two new studies.

The approach, called "neoadjuvant" chemotherapy, is being given to an increasing number of women with what's known as triple-negative breast cancer. Currently, the approach results in no identifiable cancer cells at mastectomy or lumpectomy in about-one third of patients, experts estimate. In such cases, the risk of a tumor recurrence becomes lower.

"Chemotherapy [before surgery] does work in triple-negative breast cancer. What we want to do is make it work better," said study researcher Dr. Hope Rugo.

Rugo is director of breast oncology and clinical trials education at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco.

Triple-negative cancers have cells that lack receptors for the hormones estrogen and progesterone. In addition, they don't have an excess of the protein known as HER2 on the cell surfaces. So, treatments that work on the receptors and drugs that target HER2 don't work in these cancers.

In two new studies, researchers got better results by adding drugs to the standard chemo regimen prior to surgery. However, both studies are phase 2 trials, so more research is needed.

Both studies are due to be presented Friday at the annual San Antonio Breast Cancer Symposium.

Rugo compared standard neoadjuvant therapy -- paclitaxel (Taxol, others), doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan, others) -- to standard therapy plus the drugs veliparib (investigational) and carboplatin (Paraplatin).

Of the 38 women with triple-negative cancer in the study, 52 percent of those getting the extra drugs with the standard approach had no cancer cells identified at surgery, compared with 26 percent of those on the standard therapy.

In a second study, Dr. William Sikov, at the Alpert Medical School of Brown University, and colleagues compared the standard chemotherapy using anthracycline- and taxane-based drugs with three other regimens. These added carboplatin, bevacizumab (Avastin) or both to the standard regimen.

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