Combined therapy may help women with breast cancer live longer

Combined therapy may help women with breast cancer live longer

7 Jan 2015

In a paper published by the New England Journal of Medicine, investigators at Dana-Farber Cancer Institute and other institutions report on a phase 2 clinical trial involving women with small (stage 1), HER2-positive breast tumors. The paper shows that women who received a combination of lower-intensity chemotherapy and a targeted drug following surgery were highly unlikely to have the cancer recur within 3 years of treatment.

Women with small HER2-positive breast tumors that hadn’t spread to nearby lymph nodes were excluded from clinical trials of trastuzumab. This group of patients had no single, standard treatment as it wasn’t considered prudent to expose them to an investigational drug, given the relatively low risk that the disease would recur. However, “women with small, HER-2 positive, node-negative [no sign of spread to adjacent lymph nodes] breast tumors have a low, but still significant, risk of recurrence of their disease,” said the study’s senior author, Eric Winer, MD, director of the Breast Oncology Program at the Susan F. Smith Center for Women’s Cancers at Dana-Farber.

Clinical trial design

The study enrolled 406 patients with HER2-positive, node-negative breast tumors smaller than 3 cm. In this clinical trial, they were treated with the chemotherapy agent paclitaxel and the targeted drug trastuzumab (Herceptin) for 12 weeks, followed by 9 months of Herceptin alone (and not with adriamycin and cytoxan followed by paclitaxel and trastuzumab, as they do in traditional drug regimens).

Positive results with milder side-effects

Three years after completing therapy, 98.7% of the participants were free of invasive breast cancer. The side effects were generally milder than those associated with traditional chemotherapy regimens.

Treatment approach adjusted to the stage of the cancer

According to the authors, the findings may help establish the first standard treatment approach for these women. “We’re committed to identifying treatment regimens that are geared not only to the specific biological features of a woman’s cancer, but also to the stage of the cancer– the size of the tumor and how far it has advanced,” said the study’s lead author, Sara Tolaney, MD, MPH, of the Susan F. Smith Center for Women’s Cancers at Dana-Farber.

 

Source: Science Daily