A recent study showed that trastuzumab emtansine (T-DM1), a new treatment for HER2-positive metastatic breast cancer, worked better to control the cancer growth than the current standard treatment of chemotherapy with capecitabine (Xeloda) and lapatinib (Tykerb). HER2-positive means that the breast cancer has too much of a protein called human epidermal growth factor receptor 2 (HER2).

T-DM1, the new drug found to be more effective in controlling the cancer growth, is a combination of a drug that targets HER2 and one that is similar to chemotherapy. The study of nearly 1,000 patients with metastatic HER2-positive breast cancer showed that cancer worsened three months later in patients receiving T-DM1 than in patients receiving the standard therapy. In addition, T-DM1 has few side effects, namely low levels of platelets and signs of liver function problems. These side effects went away with a break in treatment.

More information on the study can be found here.

by Barbara Good, Ph.D.

Each year the journal CA, A Cancer Journal for Clinicians, provides an analysis of cancer statistics for all cancers.  Breast cancer continues to be the most frequently diagnosed cancer and the leading cause of cancer death among women worldwide. This initial report shows that the cancer burden continues to increase worldwide, attributable in part to the fact that people now live longer than in past generations.

In the US, cancer incidence has been stable for men and has been declining in women by 0.6% yearly since 1998.

In the United States for 2011, breast cancer accounts for about 30% of diagnosed cases and 15% of cancer deaths. Pennsylvania has one of the highest rates for both incidence and death from breast cancer in the US.

A follow-up report, issued later in the year, details statistics for the United States. For the complete US report, go to: http://onlinelibrary.wiley.com/doi/10.3322/caac.20121/pdf

by Barbara C. Good, PhD

When government approval for the drug Avastin^TM  (bevacizumab) was revoked for the treatment of advanced breast cancer last November, there were protests from women who had received it and were convinced the drug helped lessen their disease or even kept them alive.  Now two studies, one from the National Surgical Adjuvant Breast and Bowel Project (NSABP) in Pittsburgh and the other from the University of Frankfurt, Germany, have demonstrated that this drug may have a role to play in the treatment of early-stage breast cancer.

Avastin in these studies was used before surgery in women whose disease had not spread.  In both studies, the women who received it had lower rates of cancer once surgery was performed.  The side effects of this drug can be serious, and additional studies are continuing to see if these results hold up.  Tissue samples from these studies are also being examined to determine if women whose tumors contain particular genetic characteristics may respond more successfully to the drug.

For additional information about these studies, click here.

Abstracts of the studies as they appeared in the New England Journal of Medicine can be found here and here.

Oncotype DX is a laboratory test developed by Genomic Health, Inc., that has been used to predict the likelihood of chemotherapy benefit and recurrence risk in ER-positive, HER2-negative early stage invasive breast cancer. A report from the San Antonio Breast Cancer Symposium held in December indicates that the test can also predict the likelihood of local recurrence for patients with ductal carcinoma in situ (DCIS).

This study indicated that the test is able to identify women with DCIS who are at low risk for recurrent disease, ie, patients who may be able to avoid radiation therapy after surgery, and those at higher risk, who may require radiation therapy. This means that those who require more treatment would be the ones to receive it, while those with a less aggressive form of DCIS would be able to avoid the side effects sometimes associated with radiation therapy.

DCIS has historically represented a challenge for physicians, who have used a wide spectrum of treatment options from breast conserving surgery with or without radiation to mastectomy. Lumpectomy has become the current standard, following a trend in breast cancer surgery to not “overtreat” patients who may have a less aggressive form of the disease.

More information on this study can be found here.