OncoLog, Volume 49, Number 11, November 2004 Page: 6
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Herceptin Boosts
Response Rates
in Breast Cancer
Adding trastuzumab (Herceptin) to
pre-surgery chemotherapy treatment
dramatically shrinks breast tumors in
women with early-stage, HER-2-positive
breast cancer, according to recent
research at M. D. Anderson Cancer
Center. Studies showed that the
addition of Herceptin to the treatment
regimen completely eradicated tumors
in twice as many women as with
chemotherapy alone (65% versus 26%).
About 25 to 30% of all breast cancer
patients have tumors that are HER-2
positive, a marker that can signal a
poorer prognosis due to increased risk of
recurrence and decreased sensitivity to
chemotherapy, said Aman Buzdar, M.D.,
professor in the Department of Breast
Medical Oncology. "This is a significant
stride in treating women with confined
breast tumors who have tested positive
for the HER-2 gene," said Buzdar.
According to Buzdar, even though
most of the breast tumors either virtu-
ally disappeared or shrank dramatically
with the presurgery chemotherapy and
Herceptin treatment, the breast still had
to be treated surgically. Buzdar said the
research team will look more closely at
the effect the treatment may have on
the type of surgery necessary after
chemotherapy.
New Blood Test Predicts
Breast Cancer Prognosis
Women with advanced breast cancer
who have more than five circulating
tumor cells in the blood may have a
more dangerous form of the disease,
according to a recent M. D. Anderson-
led study published in the New England
Journal of Medicine.
The findings could lead to more
tailored treatments that would spare
some women from the most potent
chemotherapy or, conversely, recognize: which patients need more aggressive
. therapy at the start of treatment,
said the study's lead author, Massimo
Cristofanilli, M.D., associate professor
in the Department of Breast Medical
Oncology.
"This is the first time that we can
actually stratify metastatic breast cancer
patients based on their risk," said
Cristofanilli. New technology makes it
- possible to reliably isolate circulating
tumor cells in the bloodstream with a
blood test. This study found that the
presence of cancer cells in the blood
predicted prognosis more accurately
than the site of metastatic disease or
the presence of estrogen receptor on
the tumor cells.
"If we can discover in a newly
diagnosed patient that tumor cells are
already in the blood, both patient and
physician would be aware that we are
dealing with a more aggressive cancer
that requires more aggressive treatment
early on," Cristofanilli said.
Biologic Drug Effective
In Rare Leukemia
A biologic agent, Lipo-ATRA, appears
. to be as effective as chemotherapy in
some patients with a rare form of
. leukemia, but without the risks and
negative side effects of traditional
chemotherapy.
Researchers showed that approxi-
mately one third of patients with acute
promyelocytic leukemia (APL) can
achieve long-term, disease-free remis-
* sion with the drug, a finding that opens
the door to the development of biologic
agents for more common forms of
leukemia.
"This is the first time we have
seen patients with an acute leukemia
potentially cured without use of
chemotherapy," said the study's
principal investigator, Elihu Estey,
M.D., a professor in the Department
of Leukemia at M. D. Anderson.
Traditional treatment of APL
* combines the chemotherapy drugidarubicin with orally administered
ATRA (all-trans retinoic acid), a form
of vitamin A. Realizing that little of the
vitamin A is absorbed when swallowed,
M. D. Anderson researchers worked to
find a more effective way to deliver
ATRA.
The solution involved encasing
ATRA in liposomes and injecting it
so that it is not metabolized and stays
longer in tissues. The approach was
effective-of the 34 patients who
received Lipo-ATRA, 10 remain in
remission for an average of five years,
despite never receiving chemotherapy.
Novel Agent Combination
Shrinks Lung Tumors
A combination of two new agents
shows promise in treating lung cancer,
according to studies at M. D. Anderson.
The agents have shown little benefit in
treating lung cancer but they had a
substantial impact when used individu-
ally in low doses.
In a study published in the October
20 issue of the Journal of the National
Cancer Institute, researchers tested an
experimental targeted therapy, the
farnesyltransferase inhibitor lonafarnib
(also known as SCH66336) and the
insulin-like growth factor binding
protein-3 (IGFBP-3), in mice implanted
with human lung tumors. The com-
bined treatment shrank tumors to 45%
the size of those in untreated mice.
The treatment worked even in low
doses and did not cause measurable
side effects in the mice.
"Together these agents work on the
pathway that is critical for the survival
of a cancer cell," said Ho-Young Lee,
Ph.D., assistant professor in the Depart-
ment of Thoracic/Head & Neck
Medical Oncology Research and lead
author of the study. Scientists from the
U.S. Food and Drug Administration
and Emory University also participated.
Clinical trials are under development.
*0 06 OncoLog " November 2004
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 49, Number 11, November 2004, periodical, November 2004; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth902761/m1/6/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.