Herceptin Helps Treat Early-Stage, HER2-Positive Cancers

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Herceptin (chemical name: trastuzumab) is a targeted therapy medicine approved to treat advanced-stage HER2-positive breast cancers and to lower the risk of the cancer coming back (recurrence) in women with HER2-positive, early-stage breast cancer that has a high risk of recurrence.

A study found that Herceptin also offers benefits to women diagnosed with HER2-positive, early-stage breast cancer with a low risk of recurrence. The results were presented at the 2009 ASCO Breast Cancer Symposium.

When deciding if HER2-positive, early-stage breast cancer has a high risk of recurrence, doctors look for specific cancer characteristics, including:

  • spread to the axillary (underarm) lymph nodes
  • hormone-receptor-negative
  • higher grade of cancer cells (grade 2 or 3)
  • larger tumor size (larger than 2 cm)
  • younger patient age (35 years old or younger)

Still, doctors often use Herceptin to treat many HER2-positive, early-stage breast cancers without all of these characteristics -- meaning they have a lower risk of recurrence. For example, HER2-positive breast cancers that are smaller than 2 cm are considered to have a lower risk of recurrence.

In this study, the researchers wanted to see if using Herceptin to treat HER2-positive, early-stage breast cancers with a low risk of recurrence makes sense. They looked at two groups of women:

  • 108 women diagnosed with HER2-positive, early-stage breast cancer with a low risk of recurrence. These women were treated between 2002 and 2004, before Herceptin was available. About 66% of these women were treated with chemotherapy.
  • 149 women diagnosed with HER2-positive, early-stage breast cancer with a low risk of recurrence. These women were diagnosed and treated after Herceptin was available and all the women received Herceptin and chemotherapy.

The researchers wanted to see if there were differences in outcomes between the women who got Herceptin and the women who didn't get Herceptin at 2 and 4 years after diagnosis.

Two years after diagnosis, survival was essentially the same, but Herceptin did show some small benefits:

  • Recurrence in the same breast or nearby area (locoregional recurrence) or a new cancer in the opposite (contralateral) breast was less likely in women who got Herceptin compared to women who didn't get Herceptin: 99% of the women who got Herceptin didn't have locoregional recurrence or a new cancer in the opposite breast compared to 91% of women who didn't get Herceptin.
  • Metastatic recurrence (breast cancer coming back in another part of the body) was less likely in women who got Herceptin compared to women who didn't: 100% of the women who got Herceptin didn't have a metastatic recurrence compared to 98% of women who didn't get Herceptin.

Four years after diagnosis, Herceptin showed more substantial benefits:

  • Only 0.7% of the women who got Herceptin had died compared to 2.8% of the women who didn't get Herceptin.
  • Only 1.3% of the women who got Herceptin had a locoregional recurrence or a new cancer in the opposite breast compared to 9.3% of women who didn't get Herceptin.
  • None of the women who got Herceptin had a metastatic recurrence compared to 5.6% of women who didn't get Herceptin.

The researchers pointed out that some of the recurrence reduction benefits that seemed to come from Herceptin may have been because chemotherapy was used more consistently during treatment. About 33% of the women that didn't get Herceptin also didn't get chemotherapy. Chemotherapy, like Herceptin, can reduce the risk of recurrence of both HER2-positive and HER2-negative breast cancers.

While these results are promising, more research needs to be done before researchers can be sure that using Herceptin to treat HER2-positive breast cancers with a low risk of recurrence makes sense. If you've been diagnosed with HER2-positive, early-stage breast cancer, you'll want to do all that you can to keep your risk of recurrence as low as possible. This may include chemotherapy and Herceptin treatments. Talk to your doctor about the cancer's characteristics and your risk of recurrence. You may want to discuss this study and ask if Herceptin treatment makes sense for your specific situation.

Breastcancer.org's pages on Herceptin offer much more information about this targeted therapy medicine.

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