Taxotere ®
Plus Herceptin ® Promising as Initial Therapy in Metastatic
Breast Cancer
According to a recent article published in the Journal of
Clinical Oncology, the treatment combination consisting of
Taxotere ® (docetaxel) and Herceptin ® (trastuzumab)
appears effective and well tolerated as initial therapy for
patients with HER-2 overexpressing metastatic breast cancer.1
Breast cancer claims the lives of approximately 40,000 women
annually in the United States alone. If breast cancer is caught
and treated early, cure rates remain high. However, once breast
cancer has spread to several and/or distant sites in the body,
cure rates greatly diminish. Metastatic breast cancer refers
to cancer that has spread from the breast to distant sites
in the body, often invading vital organs. Treatment for metastatic
breast cancer is typically aimed at improving a patient’s
quality of life and/or increasing the duration of survival.
Research is ongoing in an attempt to improve long-term survival
for patients with this disease.
A significant portion of patients with breast cancer over-express
the human epidermal growth factor-2 (HER-2), which is a protein
that is displayed on the outside of a cell. HER-2 is involved
in cellular growth and replication, and overexpression of
HER-2 is implicated in the uncontrolled growth of cancer.
The level of HER-2 expression may be determined through laboratory
processes. Herceptin ® (trastuzumab) is a monoclonal antibody
that has been made through laboratory processes to bind to
HER-2, and ultimately inactive or slow the growth and replication
pathway that HER-2 is involved in. Herceptin ® is currently
FDA approved in combination with paclitaxel (Taxol ®) for
the treatment of HER-2 overexpressing metastatic breast cancer,
or alone for the treatment of HER-2 overexpressing metastatic
breast cancer that has recurred following previous therapy.
Clinical trials are underway to evaluate Herceptin ® earlier
in the course of the disease of HER-2 overexpressing breast
cancer as well as in combination with various chemotherapy
agents. It has been demonstrated that the combination of Herceptin ®
plus Adriamycin ® (doxorubicin) may result in heart failure.
Although uncommon, researchers are evaluating different agents
with Herceptin ® and closely monitoring side effects.
Taxotere ® is one of the most active chemotherapy agents
in the treatment of breast cancer, and is being studied extensively
alone and in combination for various stages of breast cancer.
Taxotere ® is currently FDA approved for the treatment
of locally advanced or metastatic breast cancer that has progressed
following prior therapies. Researchers from several U.S. Cancer
centers recently conducted a clinical trial to evaluate the
combination of Taxotere ® plus Herceptin ® in the treatment
of metastatic breast cancer. This trial included 26 women
with HER-2 overexpressing metastatic breast cancer; approximately
half of whom had never received prior therapy. Patients were
allowed to only have one prior chemotherapy regimen. The overall
anti-cancer response rate for these patients was 50%. Patients
who strongly overexpressed HER-2 had an overall anti-cancer
response rate of 64%. In addition, 31% of patients experienced
disease stabilization following therapy. The average time
to cancer progression was approximately 1 year, and the average
duration of survival was nearly 2 years (22.1 months). Treatment
was generally well tolerated.
The researchers concluded that these results provide further
evidence that the combination of Taxotere ® and Herceptin ®
is an active and well tolerated treatment regimen for patients
with HER-2 overexpressing metastatic breast cancer. A previous
clinical trial indicated that Taxotere ® plus Herceptin ®
was superior to Taxotere ® alone in the treatment of HER-2
overexpressing metastatic breast cancer.2
Patients with HER-2 overexpressing metastatic breast cancer
may wish to speak with their physician about the risks and
benefits of participation in a clinical trial further evaluating
Taxotere ®/Herceptin ® or other novel therapeutic approaches.
Two sources of information regarding ongoing clinical trials
include the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches are also performed by
cancerconsultants.com.
References:
1. Docetaxel Combined with Trastuzumab is an Active Regimen
in HER-2 3+ Overexpressing and Fluorescent In Situ Hybridization-Positive
Metastatic Breast Cancer: A Multi-Institutional Phase II Trial.
Journal of Clinical Oncology. 2004;22:1071-1077.
2. Extra JM, Cognetti F, Chan S et al. First-line trastuzumab
(Herceptin ® plus docetaxel versus docetaxel alone in women
with HER2-positive metastatic breast cancer (MBC): results
from a randomized phase II trial (M77001). Breast Cancer Res
and Treat, 82: Special Issue: 26th Annual San Antonio Breast
Cancer Symposium. 2003; Abstract 217.
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