Iressa ®
Appears Active in Advanced Breast Cancer
According to results presented at the annual San Antonio Breast
Cancer Conference, Iressa ® (ZD1839) may be active in some
patients with advanced breast cancer.
Breast cancer is diagnosed in over 200,000 women and causes
approximately 40,000 deaths annually in the United States.
Metastatic breast cancer refers to cancer that has spread
from the breast to distant sites in the body and recurrent
breast cancer refers to cancer that has recurred following
previous therapies. Since long-term survival for patients
with metastatic or recurrent breast cancer remains suboptimal,
researchers are continually evaluating novel therapeutic options
in order to improve survival and/or quality of life for patients
with this disease.
It is now known that stimulation of the growth of some cancers
is facilitated by the epithelial growth factor receptor (EGFR)
pathway. EGFR is a protein that is involved in the normal
growth and replication of a cell. In some cancers, the EGFR
may not be working properly, leading to excessive replication
of the cancer cell. Novel compounds still in clinical trials,
called EGFR inhibitors, are targeted against the receptor.
Iressa ® is a small, oral agent that binds to a portion
of EGFR and blocks part of the biochemical pathway initiated
by EGFR that induces some cancer cells to grow. Iressa ®
has been studied most extensively in lung cancer, but is now
being evaluated in a variety of cancers.
One recent clinical trial involved 63 women with metastatic
breast cancer, the vast majority of whom had stopped responding
to a number of previous therapies and had cancer that was
progressing upon entering the trial. Following treatment with
Iressa ®, one patient experienced an anti-cancer response
and 8 achieved a stabilization of their disease. Several patients
noted a significant reduction in bone pain and others were
able to stop pain medications altogether. The most common
side effects were diarrhea, acne-like skin rash, nausea and
vomiting. 1
The second trial involved 22 women with breast cancer that
had stopped responding to hormonal therapy or were not candidates
for hormone therapy. One month following therapy with Iressa ®,
46% of patient's cancer had not progressed, 9% had a partial
anti-cancer response and 23% of patients had cancer progression.
The most common side effects were acne-like rash, hair loss,
nausea, vomiting and diarrhea. 2
The results from these two trials suggest that Iressa ®
may provide activity in some patients with breast cancer.
The researchers suggest that Iressa ® may prove more valuable
if utilized earlier in the course of the disease or in combination
with other treatment modalities. Additional clinical trials
evaluating Iressa ® in advanced breast cancer are currently
underway. Patients with recurrent breast cancer may wish to
speak with their physician about the risks and benefits of
participating in a clinical trial further evaluating Iressa ®
or other promising therapeutic approaches. Two sources of
information regarding ongoing clinical trials include the
National Cancer Institute ( cancer.gov) and www.eCancerTrials.com.
eCancerTrials.com also provides personalized clinical trial
searches on behalf of patients.
References:
1. Albain K, Elledge R, Gradishar W, et al. Open-label phase
II, multicenter trial of ZD1839 (?Iressa?) in patients with
advanced breast cancer. Special Issue 25th Annual San Antonio
Breast Cancer Symposium. 2002;76:S33. Abstract 20.
AstraZeneca. Data on Iressa ® (ZD1839) reported from first
trial in women with progressing advanced breast cancer. Available
at: http://www.astrazeneca-us.com/news/article.asp?file=2002121201.htm
Accessed January 10, 2003.
2. Robertson J, Gutteridge E, Cheung K, et al. A phase II
study of ZD1839 (?Iressa?) in tamoxifen-resistant ER-positive
and endocrine-insensitive (ER-negative) breast cancer. Special
Issue 25th Issue Annual San Antonio Breast Cancer Symposium.
2002;76:S96. Abstract 357.
AstraZeneca. Data on Iressa ® (ZD1839) reported from first
trial in women with progressing advanced breast cancer. Available
at: http://www.astrazeneca-us.com/news/article.asp?file=2002121201.htm
Accessed January 10, 2003.
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