FRIDAY, Dec. 13, 2013 (HealthDay News) -- Women fighting an
aggressive form of breast cancer may benefit from adding certain
drugs to their chemotherapy regimen, and taking them prior to
surgery, new research finds.
This pre-surgical drug therapy boosts the likelihood that no
cancer cells will be found in breast tissue removed during either
mastectomy or lumpectomy, according to two new studies.
The approach, called "neoadjuvant" chemotherapy, is being given
to an increasing number of women with what's known as
triple-negative breast cancer. Currently, the approach results in
no identifiable cancer cells at mastectomy or lumpectomy in
about-one third of patients, experts estimate. In such cases, the
risk of a tumor recurrence becomes lower.
"Chemotherapy [before surgery] does work in triple-negative breast cancer. What we want to do is make it work better," said study researcher Dr. Hope Rugo.
Rugo is director of breast oncology and clinical trials
education at the Helen Diller Family Comprehensive Cancer Center at
the University of California, San Francisco.
Triple-negative cancers have cells that lack receptors for the
hormones estrogen and progesterone. In addition, they don't have an
excess of the protein known as HER2 on the cell surfaces. So,
treatments that work on the receptors and drugs that target HER2
don't work in these cancers.
In two new studies, researchers got better results by adding
drugs to the standard chemo regimen prior to surgery. However, both
studies are phase 2 trials, so more research is needed.
Both studies are due to be presented Friday at the annual San
Antonio Breast Cancer Symposium.
Rugo compared standard neoadjuvant therapy -- paclitaxel (Taxol,
others), doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan,
others) -- to standard therapy plus the drugs veliparib
(investigational) and carboplatin (Paraplatin).
Of the 38 women with triple-negative cancer in the study, 52
percent of those getting the extra drugs with the standard approach
had no cancer cells identified at surgery, compared with 26 percent
of those on the standard therapy.
In a second study, Dr. William Sikov, at the Alpert Medical
School of Brown University, and colleagues compared the standard
chemotherapy using anthracycline- and taxane-based drugs with three
other regimens. These added carboplatin, bevacizumab (Avastin) or
both to the standard regimen.
The researchers randomly assigned 443 patients with
triple-negative breast cancer to one of the four groups. Those in
the combination groups were more likely to have no breast cancer
cells found at surgery than those in the standard groups. While 42
percent of those in the standard group had no breast cancer cells
identified at surgery, 50 percent to 67 percent of those in the
combination groups did not.
Genentech, which makes Avastin, funded Sikov's study. Other
supporters included the U.S. National Institutes of Health and the
Breast Cancer Research Foundation.
The research presented by Rugo is funded by a variety of
sources, included unrestricted funding from several pharmaceutical
"Every time we have studies like this, it tells us we are on to something," said Dr. Joanne Mortimer, director of women's cancer programs at the City of Hope Comprehensive Cancer Center, in Duarte, Calif. She reviewed the findings. While the approaches warrant further investigation, she cautions that ''both these studies have very small numbers."
Complicating the issue, she said, is that "triple-negative is
not a single disease." There are several subtypes, and patients
respond differently to treatments. "This [research] is very
interesting, but until we know which actual specific patient's
tumors are going to benefit, it's hard to apply this to the
population," Mortimer said.
Studies presented at medical conferences are considered
preliminary since they have not yet had the independent scrutiny
required for publication in most medical journals.
To learn more about triple-negative breast cancer, visit the
American Cancer Society.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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