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.
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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