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Friday, October 21, 2005Herceptin has been in use for several years. It's usually used to treat breast cancer that has spread elsewhere. It is only effective against a certain subtype of breast cancer, those that have too many HER2-receptors on their surfaces. No one knows why, exactly, but if something happens to a cell's HER2 gene that causes the cell to manufacturer too many HER2-receptors, the cell's growth goes wacky and it generates a tumor. Although no one knows exactly how hereceptin works its magic, it has some effect on those HER2 receptors. Theories abound. What has caught the attention of the media is this week's New England Journal of Medicine which ran two studies of the drug. One study looked at the incidence of breast cancer recurrence in women treated with herceptin after having undergone surgical resection and chemotherapy or radiation therapy for their HER2-positive breast cancer. The herceptin was started after their traditional therapy had ended. Women with metastatic cancer were excluded. The results were rather impressive. After one year, there were 127 breast cancer recurrences in those treated with herceptin, comopared to 220 recurrences in those not treated. But there's a rub - and a big one. The survival rates for the two groups after a year were the same. The second study looked at herceptin as an adjunct to paclitaxel, another cancer drug that is given after conventional radiation and/or chemotherapy. (And which, incidentally, comes from Yew trees.) This study followed patients for three years. At the end of that time, 94% of the patients treated with both herceptin and taxol were still living, compared with 91% of those who had just received taxol. Even more significantly, at the end of three years 90% of women who had received herceptin and taxol had no distant spread of their cancer, but only 84% of women receiving taxol alone could make that claim. So, it does seem to make a difference in cancer recurrence and spread, but it isn't a dramatic life saver. Considering how little we know about the drug's mechanism of action, and how little we know about the true role of HER2 receptors in normal cell physiology, it's not unreasonable to think that there might be some consequences of the drug for normal cells. Don't sell your house for it. ADDENDUM: Although the first article I linked to indicated the cost of the drug was $4800 for a year, other estimates are considerably higher - up to $15,600 for a 24-week course. ASIDE: The first study has one of those clever acronyms that are so popular among medical researchers. It's the Herceptin Adjuvant Trial - HERA for short. Hera, of course, was Zeus's "buxom bride", goddess of marriage, and Queen of Heaven, from whose breasts the Milky Way flowed. posted by Sydney on 10/21/2005 08:55:00 AM 0 comments 0 Comments: |
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