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Lani · 01-03-2014, 10:56 AM

cyclines like doxyrubicin, epirubicin add toxicity (cardiac damage, leukemia, etc) to adjuvant treatment without adding any incremental benefit to a taxane+ carboplatin+herceptin regimen for her2+ breast cancer patients

REPRINT: Study Identifies Highly Effective Treatment Option for Patients With HER2-positive Breast Cancer
[American Association for Cancer Research]
SAN ANTONIO — Combining the chemotherapy drugs docetaxel and carboplatin with the HER2-targeted therapy trastuzumab was identified to be an ideal postsurgery treatment option for patients with HER2-positive breast cancer, regardless of tumor size and whether or not disease has spread to the lymph nodes, according to results from the BETH study presented here at the 2013 San Antonio Breast Cancer Symposium, held Dec. 10-14.

"Worldwide, anthracyclines such as doxorubicin [Adriamycin] and epirubicin have dominated breast cancer treatment for decades because of a perceived incremental benefit of 3 to 5 percent in disease-free survival and overall survival that was observed in meta-analysis overview studies that viewed breast cancer as a single disease," said Dennis J. Slamon, M.D., Ph.D., director of clinical/translational research at the University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center, and professor of medicine and chief of the Division of Hematology/Oncology at the UCLA Department of Medicine. "It turns out that anthracyclines were particularly active in the treatment of HER2-positive disease once we applied molecular subtype analyses to breast cancers. These data were derived from treatments used before the development of trastuzumab. In HER2-positive breast cancers, anthracyclines improved outcomes dramatically while adding little or no incremental benefit to the other subtypes that represent 75 to 80 percent of the disease. Unfortunately, the long-term side effects of anthracyclines in all groups include congestive heart failure and leukemia. We and others have previously shown that adding trastuzumab to anthracycline-based therapy in adjuvant disease increases this cardiac toxicity between three- to fivefold.

"Our new results, which surpassed our expectations, show that it really is not necessary to include an anthracycline as part of the treatment regimen to obtain really ideal results for patients with HER2-positive breast cancer, even if they have a large tumor or have node-positive disease," added Slamon, who is also a leader of a Stand Up To Cancer Dream Team. "The importance of the results lies in the fact that the TCH [docetaxel, carboplatin, and trastuzumab] combination has a much better safety profile than anthracycline and trastuzumab combinations and is now equally effective."

01-03-2014, 10:56 AM	#1
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	Ding-Dong! the anthracyclines are dead! SABCS presentation by Dr Slamon shows anthra- cyclines like doxyrubicin, epirubicin add toxicity (cardiac damage, leukemia, etc) to adjuvant treatment without adding any incremental benefit to a taxane+ carboplatin+herceptin regimen for her2+ breast cancer patients REPRINT: Study Identifies Highly Effective Treatment Option for Patients With HER2-positive Breast Cancer [American Association for Cancer Research] SAN ANTONIO — Combining the chemotherapy drugs docetaxel and carboplatin with the HER2-targeted therapy trastuzumab was identified to be an ideal postsurgery treatment option for patients with HER2-positive breast cancer, regardless of tumor size and whether or not disease has spread to the lymph nodes, according to results from the BETH study presented here at the 2013 San Antonio Breast Cancer Symposium, held Dec. 10-14. "Worldwide, anthracyclines such as doxorubicin [Adriamycin] and epirubicin have dominated breast cancer treatment for decades because of a perceived incremental benefit of 3 to 5 percent in disease-free survival and overall survival that was observed in meta-analysis overview studies that viewed breast cancer as a single disease," said Dennis J. Slamon, M.D., Ph.D., director of clinical/translational research at the University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center, and professor of medicine and chief of the Division of Hematology/Oncology at the UCLA Department of Medicine. "It turns out that anthracyclines were particularly active in the treatment of HER2-positive disease once we applied molecular subtype analyses to breast cancers. These data were derived from treatments used before the development of trastuzumab. In HER2-positive breast cancers, anthracyclines improved outcomes dramatically while adding little or no incremental benefit to the other subtypes that represent 75 to 80 percent of the disease. Unfortunately, the long-term side effects of anthracyclines in all groups include congestive heart failure and leukemia. We and others have previously shown that adding trastuzumab to anthracycline-based therapy in adjuvant disease increases this cardiac toxicity between three- to fivefold. "Our new results, which surpassed our expectations, show that it really is not necessary to include an anthracycline as part of the treatment regimen to obtain really ideal results for patients with HER2-positive breast cancer, even if they have a large tumor or have node-positive disease," added Slamon, who is also a leader of a Stand Up To Cancer Dream Team. "The importance of the results lies in the fact that the TCH [docetaxel, carboplatin, and trastuzumab] combination has a much better safety profile than anthracycline and trastuzumab combinations and is now equally effective."