The National Comprehensive Cancer Network (NCCN) has recently added HER2 testing and the use of the targeted agent Herceptin® to their guidelines for treatment of early breast cancer.
The NCCN consists of a panel from the nation’s most reputable cancer treatment facilities. The panel sets clinical guidelines that are continually refined and include algorithms for diagnostic procedures and treatment of cancer. For 2005, the NCCN has fine-tuned recommendations for treatment of early and advanced breast cancer.
Approximately 30% of cancers overexpress a protein referred to as the human epidermal growth factor receptor-2 (HER2) protein. The HER2 protein is involved in cellular growth and replication. Fortunately, the targeted agent Herceptin (trastuzumab) binds to HER2 receptors and prevents or reduces replication of cancer cells that overexpress HER2.
Herceptin is currently approved by the FDA for the treatment of patients with HER2-overexpressing metastatic breast cancer as a single agent, or for those who have received at least one prior chemotherapy regimen for metastatic disease. It is also approved for use in combination with paclitaxel for the treatment of metastatic breast cancer in patients who overexpress HER2 and have not received prior treatment for their metastatic disease.
Results from recent large clinical trials have demonstrated that the addition of Herceptin to chemotherapy significantly improves outcomes among women with early breast cancer who overexpress HER2 compared with chemotherapy alone. The addition of Herceptin to chemotherapy is generally well tolerated.
The NCCN’s recent guidelines include the testing for the expression of the HER2 protein in early breast cancer and the administration of Herceptin in those women who overexpress HER2. These guidelines differ from previous guidelines that recommended HER2 testing and Herceptin to patients with metastatic or recurrent breast cancer.
Patients who have been diagnosed with breast cancer should speak with their physician regarding testing for HER2.
Reference: National Comprehensive Cancer Network. Practice Oncology Guidelines- Invasive Breast Cancer. Available at: http://www.nccn.com/professionals/physician_gls/PDF/breast.pdf. Accessed December 2005.
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