According to a recent article published in Breast Cancer Research and Treatment, the status of the human epidermal growth factor-2 (HER-2) receptor in patients with breast cancer affects responses to the two commonly used chemotherapy agents Taxotere® (docetaxel) and doxorubicin (Adriamycin®). These results provide further evidence that individualized treatment regimens may provide optimal outcomes for patients with cancer.

Breast cancer claims the lives of approximately 40,000 women annually in the United States alone. Chemotherapy is a common treatment component of nearly all stages of breast cancer, demonstrating a reduction in cancer recurrences, improvement in survival and/or improvement in quality of life in patients. There are several different chemotherapy agents and/or combinations of agents that are used to treat breast cancer and researchers have been evaluating reasons to explain why some patients respond differently than others to certain agents or regimens.

The HER-2 receptor belongs to a family of receptors that is involved in cellular growth and replication. Some patients with breast cancer overexpress HER-2, and are referred to as HER2-positive. All patients should be tested for HER-2 positivity, as the monoclonal antibody Herceptin® (trastuzumab) is approved for the treatment of HER-2 breast cancer. Researchers have been evaluating the possible biologic correlations between HER-2 overexpression and characteristics of cancer that may help to provide optimal therapeutic approaches to patients.

Researchers from several institutions including Europe, Canada and South Africa recently conducted a clinical study to evaluate a possible relationship between HER-2 status and responses to the chemotherapy agents Taxotere® or doxorubicin in the treatment of breast cancer. This study included 176 patients with advanced breast cancer who were treated with either Taxotere® or doxorubicin alone. Twenty percent of the patients were HER-2-positive. Patients who were HER-2-positive had approximately 3 times the anti-cancer response rates when treated with Taxotere® compared with doxorubicin. However, at the time of the publication of these results, there was no significant difference between cancer progression and overall survival between patients treated with either agent. In addition, there was no difference in treatment responses between the two agents in patients who did not overexpress HER-2.

The researchers concluded that breast cancer patients who are HER-2-positive may have greater anti-cancer responses to Taxotere® compared to doxorubicin, providing further evidence that individualized treatment options may ultimately improve long-term outcomes. Longer follow-up will reveal if these results translate into differences in survival. The researchers stated that further trials need to be conducted in order to confirm these findings, while ongoing trials are evaluating HER-2 status in addition to other biologic markers and possible relations in treatment outcomes. Patients diagnosed with breast cancer may wish to speak with their physician about their individual risks and benefits of participating in a clinical trial further evaluating relationships between markers and treatment outcomes. 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 on behalf of the patient at cancerconsultants.com.

Reference: Di Leo A, Chan S, Paesmans M, et al. HER-2/neu as a predictive marker in a population of advanced breast cancer patients randomly treated either with single-agent doxorubicin or single-agent docetaxel. Breast Cancer Research and Treatment. 2004;86:197-206.

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