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HER-2/neu vs. Breast Cancer

By Sean Henahan, Access Excellence

all this, and her2Los Angeles, CA (5/18/98)- Favorable results with a new antibody therapy against breast cancer, HER-2/neu (Herceptin),  herald a new era of treatment based on molecular targeting of tumor cells, reported researchers at the annual meeting of the American Society of Clinical Oncology.

The HER-2/neu proto-oncogene encodes a growth factor receptor that is overexpressed in 20-30% of metastatic breast cancers. This overexpression is associated with decreased survival and decreased relapse-free periods. The anti-HER2 antibody is designed to block this receptor.

The long-awaited results from a large clinical trial of Herceptin combined with chemotherapy regimens (paclitaxel or anthracycline plus cyclophosphamide) compared to chemotherapy alone indicate that adding this antibody to chemotherapy did increase the clinical benefit by slowing the progression of the cancer and increasing tumor shrinkage, reported Dennis Slamon MD. PhD, UCLA School of Medicine, division of Hematology/Oncology.

Adding Herceptin to standard chemotherapy increased the amount of time before the disease spreads by approximately three months, and increased tumor response rates by 23-32%, depending on the chemotherapy regimen used, without significant side effects.

Results of a second, large trial looking at the efficacy and safety of Herceptin treatment alone in patients with metastatic disease who had undergone prior chemotherapy regimens also appears to produce clinical benefit.

"We are at a very exciting point where what we have learned in the laboratory about the molecular basis for cancer can be translated into clinical trials, and eventually used in patients," said Lori J.Goldstein, MD, Director of the Breast Cancer Research Program at Fox Chase Cancer Center, Philadelphia, at an ASCO press conference.

"These studies, especially the approach utilizing HER2/Neu, show that molecular targeting can effectively fight advanced breast cancer, and that biotherapy can be used to augment current therapy. These approaches are showing clinical significance not just in the treatment of breast cancer, but also, perhaps, in early detection and prevention," added Dr. Goldstein.

Nearly a third of women with breast cancer have tumors that overexpress HER2. Now that there is a treatment available for this group of  high-risk patients, it is likely that screening for HER2 overexpression will become much more common than it is now. This in turn might allow earlier treatment of patients with one of the most aggressive forms of breast cancer known.

HER-2/neu is also overexpressed in a number of other cancer types including endometrial cancer, gastric cancer and prostate cancer. A preliminary clinical study using a different version of the HER-2/neu antibody showed some improvement in patients with prostate and kidney cancer.

"Our investment in cancer research is clearly paying off with a host of exciting new approaches to treating the disease," said Lynn M. Schuchter, MD, of the University of Pennsylvania Cancer Center. "Efforts over the last 15 years to understand the biology of  cancer - the cellular, molecular and genetic basis for the disease - are now making their way from the laboratory to the bedside."

Herceptin is still considered an investigational new drug, not yet approved for general use. However, the drug has been granted 'fast track' status and is expected to gain approval by the end of the year. Meanwhile, patients eligible for treatment via clinical trial can obtain information by calling the National Cancer Institute at 800-4-CANCER.

Related information on the Internet
National Cancer Institute
 American Society of Clinical Oncology
 Onco Link
Herceptin Video
Starving Tumors

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