New Treatment Standard Offered for Metastatic HER2-Positive Disease

The first treatment for HER2-positive, metastatic breast cancer is usually a taxane chemotherapy medicine and the targeted therapy Herceptin (chemical name: trastuzumab).

Taxane chemotherapy medicines are:

• Taxol (chemical name: paclitaxel)
• Taxotere (chemical name: docetaxel)
• Abraxane (chemical name: albumin-bound paclitaxel)

The combination of Taxotere and Herceptin is considered the standard first treatment for HER2-positive, metastatic breast cancer because research has shown that this combination works better than chemotherapy alone.

A study suggests that the combination of Navelbine (chemical name: vinorelbine) and Herceptin may be better than Taxotere and Herceptin as the first treatment for HER2-positive, metastatic breast cancer. These results were presented at the 2010 European Breast Cancer Symposium.

Navelbine is a chemotherapy medicine, but is not a taxane.

In this study, half of 284 women diagnosed with HER2-positive, metastatic breast cancer were treated with Taxotere and Herceptin. The other half were treated with Navelbine and Herceptin. The women were followed for about 2.5 years.

Compared to the women who got Taxotere and Herceptin, the women who got Navelbine and Herceptin:

• had the treatment work longer: 7.7 months compared to 5.6 months
• had better overall survival: 39 months compared to 36 months; still, this difference wasn't statistically significant so could have been due to chance and not because of the different treatment
• had more time before the cancer grew: 15.3 months compared to 12.4 months; still, this difference also wasn't statistically significant so could have been due to chance and not because of the different treatment

The women who got Navelbine and Herceptin also were less likely to develop the following side effects:

• low white blood cell counts (leucopenia)
• fever with a low white blood count
• infection
• nerve pain (neuropathy)
• nail changes
• swelling

Only 6.5% of women who got the Navelbine combination stopped treatment because of side effects compared to 20.1% of the women who got the Taxotere combination.

Based on these results, the researchers suggested that Navelbine and Herceptin may be better than Taxotere and Herceptin as the first treatment for HER2-positive, metastatic breast cancer.

If you've been diagnosed with HER2-positive, metastatic breast cancer, it's likely that your first treatment will be Herceptin and a chemotherapy medicine. Your doctor may recommend a taxane such as Taxotere. Your doctor has good reasons for this recommendation and the results of this study don't mean that choice is a bad one. Still, if you haven't started treatment yet, you might want to ask your doctor about this study and whether Navelbine might be a good choice for you and your unique situation.

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