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Breast cancer treatment: Herceptin long lasting benefits

New research confirms long-lasting benefit of trastuzumab (herceptin) for women with early-stage breast cancer
By
WebMD Health News
Medically Reviewed by Dr Farah Ahmed
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25th February 2010 - A new study confirms the long lasting benefit of trastuzumab (Herceptin) treatment after chemotherapy for women with aggressive early-stage breast cancer.

The new international research looked at women with HER2-positive breast cancer who were treated for a year with trastuzumab (Herceptin) following standard chemotherapy.

They found the treatment left women with a significantly lower risk of the cancer returning - and the effect is long lasting.

Experts are now debating whether it would be better to give trastuzumab at the same time as chemotherapy, rather than one after the other.

Trastuzumab (Herceptin)

Around 20-30% of women with breast cancer have HER2-positive cancer and are at high risk of the cancer coming back and of them dying from the disease.

Trastuzumab is a biological therapy known as a monoclonal antibody designed to treat these women. Antibodies are part of the body’s immune system and destroy harmful cells like viruses and bacteria. Trastuzumab antibodies destroy cancer cells that are HER2-positive. It is given through a drip in hospital.

The study

More than 5000 women from 39 countries were studied between December 2001 and June 2005. They were randomly assigned to observation only, trastuzumab for one year or trastuzumab for  two years.

After one year, the risk of the cancer returning was reduced by 46%.

Following these early results, more than half of the patients who were just being observed and were cancer free were then given trastuzumab. These patients had fewer recurrences than patients remaining on observation alone.

A follow up after two years confirmed the significant one year improvements.

After four years, trastuzumab was associated with a better chance of being disease free than with chemotherapy alone - 78.6%  compared with 72.2%. The likelihood of the cancer coming back was reduced by 24%.

There was no significant difference in risk of death between the trastuzumab groups and the observation group, which the researchers say was probably due to many observation patients being moved on to trastuzumab treatment.

‘These results are positive’

The researchers say trastuzumab was generally well tolerated, however there were 44 “cardiac events” when trastuzumab was added to chemotherapy compared with 28 cardiac events in patients receiving chemotherapy only.

Experts say more research is needed on the heart risks linked to concurrent use of trastuzumab and anthracycline-based chemotherapy.

The authors say their findings confirm that giving trastuzumab after chemotherapy is “associated with significant and persisting benefits,” and remains an appropriate treatment in patients with HER-2 positive early breast cancer.

However, they say the ideal duration of trastuzumab therapy is still the subject of ongoing research.

The study is published in the Lancet Oncology online first.

Reacting to the study results in an emailed statement, Dr Rachel Greig, Senior Policy Officer at Breakthrough Breast Cancer, says: “These results are positive. They clearly show the benefit of using Herceptin after chemotherapy for patients with this aggressive form of early breast cancer.

“What's even more reassuring is that this is already standard practice in the UK meaning lots of women continue to benefit from this type of treatment.  However, if anyone is concerned about their treatment they should speak to their doctor.”

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