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New Treatment for Aggressive Breast Cancer Shows Some Promise

Early studies found small improvement with combo therapy for HER2-positive disease

WebMD News from HealthDay

Study found 2-drug treatment reduced death risk

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Women with aggressive breast cancer who receive combination targeted therapy with chemotherapy prior to surgery have a slightly improved chance of staying cancer-free, researchers say.

However, the improvement was not statistically significant and the jury is still out on combination treatment, said lead researcher Dr. Martine Piccart-Gebhart, chair of the Breast International Group, in Brussels.

"I don't think that tomorrow we should switch to a new standard of care," she said.

Piccart-Gebhart presented her findings Wednesday at the 2013 San Antonio Breast Cancer Symposium, alongside other research that investigated ways to improve treatment for women with HER2-positive breast cancer. This aggressive form of cancer is linked to a genetic irregularity.

Other researchers reported the following:

  • The targeted drug trastuzumab (Herceptin) worked better in HER2-positive breast cancer tumors containing high levels of immune cells.
  • A combination of the chemotherapy drugs docetaxel and carboplatin with Herceptin appeared to be the best postsurgery treatment option.

Overall, the studies were good news for women with HER2-positive breast cancer, which used to be one of the most fatal forms of the disease. Researchers reported long-term survival rates higher than 90 percent for women treated using the targeted therapy drugs.

"That tells you these treatments are very, very effective," Piccart-Gebhart said.

Piccart-Gebhart's combo targeted therapy trial is evaluating whether the HER2-targeted drugs Herceptin and lapatinib (Tykerb) work better when combined on top of standard chemotherapy.

The trial involved 455 patients with HER2-positive breast cancer with tumors larger than 2 centimeters.

The women were given chemotherapy prior to surgery along with either Herceptin, Tykerb, or a combination of the two targeted drugs. They also were treated after surgery with whichever targeted therapy they had been receiving.

Piccart-Gebhart reported that 84 percent of the patients who received the combination targeted therapy between 2008 and 2010 have remained cancer-free, compared with 76 percent who only received Herceptin.

"It's too early today to say this dual treatment saves more lives. We can't say that on the basis of this trial," she noted.

The drawbacks of this combination therapy are cost and side effects, Piccart-Gebhart said. Targeted therapies cost tens of thousands of dollars, and combining the two drugs increases toxic side effects such as diarrhea and rash.

"There is a price to pay in terms of side effects," she said. "There will be a price to pay in terms of drug costs."

This study was supported by funds from GlaxoSmithKline. Piccart-Gebhart has received honoraria from Roche, and her institution has received research funding from GlaxoSmithKline.

The second study involved 156 patients who received chemotherapy and Herceptin before surgery. However, this study focused on the levels of immune cells called lymphocytes that had infiltrated the breast tumors.

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