Less
Frequent Dosing with Herceptin ® As Effective and More
Convenient for Breast Cancer
According to results recently published in the Journal of
Clinical Oncology, Herceptin ® (trastuzumab) given every
3 weeks appear just as effective as the standard weekly dosing
in the treatment of advanced breast cancer. 1
Breast cancer is responsible for approximately 40,000 deaths
annually in the United States alone. Metastatic breast cancer
refers to cancer that has spread from the breast to several
and/or distant sites in the body, often invading vital organs.
Although cure rates for breast cancer that is localized and
has not spread from its site of origin are high, cure rates
with standard treatment for metastatic breast cancer remain
dismal. Treatment for metastatic breast cancer is typically
not administered with curative intent, but rather to improve
quality of life and/or improve the duration of survival. Taxanes
(Taxotere ® or paclitaxel) are among the most active chemotherapy
agents used for the treatment of breast cancer.
A type of breast cancer, referred to as human epithelial
receptor 2 (HER2)-positive breast cancer, is characterized
by the overexpression of HER2 proteins on the surface of the
cancer cells. HER2-positive breast cancer is stimulated to
grow through biological mechanisms and tends to be aggressive
in nature. Herceptin ® (trastuzumab) is a monoclonal antibody
that is specifically targeted against HER2-positive cancers
and is approved for the treatment of HER2-positive breast
cancer. Monoclonal antibodies are proteins that can be synthesized
through laboratory processes to recognize and bind to very
specific parts of a cell. This binding action stimulates the
immune system to fight the cancer and is also implicated in
the direct killing of the cancer cell to which it is bound.
Herceptin ®, which is often administered with chemotherapy,
but can be used alone, is typically given every week.
Researchers from Canada recently conducted a clinical trial
to evaluate the effectiveness of Herceptin ® given every
3 weeks in the treatment of metastatic breast cancer. This
trial involved 32 women with HER2-positive breast cancer;
78% of whom had received prior chemotherapy. Patients were
treated with Herceptin ® plus paclitaxel (Taxol ®),
a commonly used chemotherapy agent in the treatment of breast
cancer. Standard dosing for Taxol ® is once every 3 weeks,
so researchers administered both Herceptin ® and Taxol ®
just once every 3 weeks. Anti-cancer responses were achieved
in nearly 60% of patients, and 22% of patients achieved disease
stabilization. This dosing schedule was well tolerated.
The researchers concluded that Herceptin ® given every
3 weeks appears just as effective as every week in the treatment
of metastatic HER2-positive breast cancer. A future clinical
trial directly comparing schedules of Herceptin ® given
once every 3 weeks to once every week may provide confirmatory
evidence that less frequent dosing produces just as effective
results. A schedule of once every 3 weeks compared to weekly
administration would mean improved quality of life for patients
by eliminating two-thirds of the office visits for receiving
Herceptin ®, as well as an estimated savings of $10,000.00
per year for every patient in medical costs. 2 Patients with
HER2- positive breast cancer may wish to speak with their
physician about the risks and benefits of receiving treatment
once every 3 weeks with their physician, or the participation
in a clinical trial further evaluating this scheduling issue.
Two sources of information regarding ongoing clinical trials
include the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches on behalf of patients
are also performed by cancerconsultants.com.
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