Precision Medicines Improve Outcomes of Women with HER2-positive Uterine Cancer
by Dr. C.H. Weaver M.D. 7/2020
Combining the precision cancer medicine Herceptin (trastuzumab) with chemotherapy significantly improves survival rates for women with uterine serous carcinoma (USC) a rare form of endometrial cancer according to a study published today in the journal Clinical Cancer Research.
Each year, more than 65,650 women in the United States are diagnosed with endometrial cancer, and over 12,590 die of the disease. USC accounts for 3% to 10% of endometrial cancers but results in mortality over 40% of the patients. Some women with USC also over express HER2 (human epidermal growth factor 2) a receptor on the surface of cancer cells. When HER2 is "turned on" it causes the cells to grow and reproduce. Over expression of HER2 leads to increased cell production or cancer.
Doctors can test for HER2 with a variety of tests and HER2 + "positive" cancers can be treated with precision cancer medicines that target the HER2 receptor. There are several precision cancer medicines that target HER2 and the use of these medications improves the outcomes of women with HER2-positive cancers.
In the current study 58 women with uterine serous carcinoma whose tumors expressed high levels of the HER2 protein, were treated with either a standard chemotherapy regimen of carboplatin and paclitaxel, or the same combination chemotherapy regimen followed by Herceptin. Trastuzumab targets HER2, a surface receptor, and has long improved outcomes for many women whose breast cancers display high levels of HER2 expression.
The Herceptin combination therapy was particularly effective among 41 women with advanced stage 3 and stage 4 USC receiving their first treatment for the disease. These women survived twice as long without cancer progression compared to women treated with chemotherapy alone.
Among the 17 women in the study with recurrent USC the combination treatment prolonged the disease-free interval but did not significantly improve survival when compared to the standard chemotherapy regimen.
Women with uterine cancer should discuss the role of biomarker and NGS testing with their doctor. In addition to HER2 other cancer driving mutations are being identified that can be treated with precision cancer medicines.
Fader AN, et al "Randomized phase II trial of carboplatin-paclitaxel versus carboplatin-paclitaxel-trastuzumab in uterine serous carcinoma that overexpresses HER2/neu: Updated survival analysis" SGO 2020; Abstract 12.