A UK led study has found that the drug Herceptin can help women receiving chemotherapy for certain aggressive breast cancers live longer.

The study is published in the latest issue of The Lancet. It was conducted by a large international team of 24 scientists, led by Professor Ian Smith of London’s Royal Marsden Hospital and is part of the HERA (Herceptin Adjuvant) project.

Previous studies have shown that Herceptin, the brand name (Roche Holdings AG) for Trastuzumab, can prevent a return of the disease for up to 25 per cent of women with a type of early breast cancer known as HER2 receptor positive. This new study adds increased survival rate to that finding.

The scientists did find one drawback. 2 per cent of women taking Herceptin are likely to experience non-fatal heart damage as a side-effect. It is still early days to verify if that is permanent.

The study randomly selected 1,703 eligible women to be treated with Herceptin one year after surgery and chemotherapy. Another 1,698 eligible women were in a control group where they did not receive the additional treatment after their chemotherapy.

All the women had to be HER2 positive and to have received adjuvant chemotherapy.

At the end of the 2-year period, 59 of the patients receiving Herceptin had died, compared to 90 in the control group. This translates into a 2.7 per cent survival benefit after three years, the researchers said.

Professor Smith was keen to emphasise, in a podcast interview, that the multi-centre trial was truly international, with every continent and major country represented. The exception was the US, who have conducted their own trials on Herceptin.

Herceptin is a monoclonal antibody that targets the HER2 receptor – a growth factor enzyme that lives on the surface of cells and plays an important role in controlling cell division. It is controlled by the associated gene HER2, sometimes called HER2/neu. In about 20 to 30 per cent of breast cancers the HER2 gene is “overexpressed”, there are basically too many copies of it, causing too many HER2 receptors.

When a tumour test returns as HER2 positive it means that the HER2/neu gene is overexpressed and the cancer is likely to be rapid in progression, have an increased risk of spreading, and have a poorer prognosis.

The cost of treatment with Herceptin has been estimated to be in the region of 60,000 dollars per patient. This was the main cause of the controversy in the UK where the drug was eventually “fast-tracked” for approval and has now been available on the National Health Service (NHS) for a year. Another reason the drug is controversial was mentioned by Professor Smith, who said it could still be early days, despite the dramatic results.

“2-year follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer: a randomised controlled trial.”
Prof Ian Smith MD, Marion Procter MSci, Prof Richard D Gelber PhD, Sébastien Guillaume MSc, Andrea Feyereislova MD, Prof Mitch Dowsett PhD, Prof Aron Goldhirsch MD, Prof Michael Untch MD, Gabriella Mariani MD, Prof Jose Baselga MD, Prof Manfred Kaufmann MD, David Cameron MD, Prof Richard Bell MD, Prof Jonas Bergh MD, Prof Robert Coleman MD, Andrew Wardley MD, Prof Nadia Harbeck MD, Roberto I Lopez MD, Prof Peter Mallmann MD, Prof Karen Gelmon MD, Nicholas Wilcken PhD, Prof Erik Wist PhD, Pedro Sánchez Rovira MD, and Prof Martine J Piccart-Gebhart MD.
The Lancet 2007; 369:29-36
DOI:10.1016/S0140-6736(07)60028-2

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Written by: Catharine Paddock
Writer: Medical News Today