For many women, breast cancer may seem like a death sentence.
But scientists in Europe may have found a new treatment option that could increase survivability in women with aggressive breast cancer.
The recent Cancer Research UK-funded trial found that it is possible to treat breast cancer without needing to undergo chemotherapy. Remarkably, thanks to a cocktail of two breast cancer drugs, 11 percent of the cancers were found to have entirely disappeared within just two weeks. A further 17 percent of cases featured dramatically shrunken tumors after a simple change in treatment (1).
The Deal On Breast Cancer
HER2 (human epidermal growth factor) is a protein found on the surface of normal breast cells. It can also affect the growth of some cancer cells. Some cancerous breast cells have a very high number of HER2 receptors. They are called HER2 positive breast cancers. The extra receptors may result in cancer cells growing and dividing at an accelerated rate (3).
It’s estimated that 15-25% of female breast cancer patients suffer from an HER2 positive cancer. This kind of cancer is diagnosed through a biopsy after the initial cancer diagnosis through immunohistochemistry.
Breast Cancer Drugs
In the ground-breaking study, researchers focused on Herceptin and Tykerb , two commonly used cancer drugs.
Both drugs are considered to be neoadjuvant treatment, meaning that it’s meant to be used to shrink tumors before the main treatment. These treatments are typically used alongside chemotherapy and surgery.
In the case of Herceptin and Tykerb, the treatments to block the communication of growth signals between cancer cells. They also induce cell death, or apoptosis.
In the first part of the study, 130 women diagnosed with HER2-positive breast cancer received the following treatment for 11 days before surgery:
- 22 women: no treatment (the control group)
- 51 women: Herceptin only (6 mg per kg of body weight on days one and eight)
- 57 women: Tykerb only (1,500 mg per day)
In the control group, no women experienced a change in the cancer status of the tumor removed during surgery. The Tykerb-only group experienced the same results as the control group. However, in the Herceptin-only group, one woman had a pathologic complete response and one woman had minimal residual disease.
In the second part of the study, 127 newly diagnosed women were separated into 3 treatment groups:
- 29 women: no treatment (the control group)
- 32 women: Herceptin only
- 66 women: Herceptin and Tykerb in combination
As with the first test, the researchers compared cancer tissue samples removed during the first biopsy and a sample of the mass removed after the 11 days of treatment.
In the control group, no women experienced a change in the cancer status of the tumor removed during surgery. In the Herceptin-only group, no women had a pathologic complete response and one woman had minimal residual disease. Shockingly, in the Herceptin-Tykerb group, 7 women had a pathologic complete response and 11 women had minimal residual disease. The cancer tissue samples also showed a drop in Ki-67 protein levels, which is a marker of proliferation.
A Word From The Researchers
“This has ground-breaking potential because it allows us to identify a group of patients who, within 11 days, have had their tumors disappear with anti-HER2 therapy alone and who potentially may not require subsequent chemotherapy,” said Dr. Nigel Bundred, professor of surgical oncology at the University of Manchester, who presented the study. “This offers the opportunity to tailor treatment for each individual woman.”
Dr. Judith Bliss, of the Institute of Cancer Research, London, who also co-leader of the trial said “These results show that we can get an early indication of pathological response within 11 days, in the absence of chemotherapy, in these patients on combination treatment…Most previous trials have only looked at the pathological response after several months of treatment. Clearly these results need further confirmation, but I suspect the excitement from seeing the speed of disappearance of the tumors will mean that several trials will attempt to confirm these results.”
Currently, Herceptin’s licensing does not allow for it to be used without chemotherapy. Meaning that the study may unlock new possibilities for cancer treatment.
As you know, chemotherapy has incredibly negative side-effects, including hair loss, extreme fatigue, cognitive decline, and illness. Worst yet, the treatment spans over months, dragging out these symptoms too. Some doctors have even gone so far as to say the chemotherapy kills more people than cancer does. However, the drugs used in the study have their own risks.
Side-effects of Herceptin include cardiac failure, potentially fatal lung damage, and myalgia. Other common effects include fever and chills, nausea, vomiting, pain, headache, dizziness, dyspnea, hypotension, rash, and asthenia. It also includes infusion reactions, diarrhea, infections, increased cough, headache, fatigue, rash, neutropenia, and anemia (5).
Lapatinib, also called Tyverb or Tykerb, switches off HER2 to make the cells stop growing or die outright. Side effects include diarrhea, skin changes, illness, fatigue, hand-and-foot syndrome, loss of appetite, indigestion, headache, sleeping problems, and muscle and joint pain. Other issues include fertility problems, liver injury, heart problems, nose bleeds, hot flashes, coughing, breathing difficulty, mouth pain, and abdominal pain (6).
Most of these side-effects are experienced by as many as ¼ or 1/3 of patients.
Women who were treated with a combination of Herceptin and Tykerb before surgery experienced the same side effects Tykerb alone, but more severely.
As it stands, cancer research doesn’t really explore non-pharmaceutical treatment as a viable medical solution. However, as there are an increasing amount of patients that cure their own disease, we can only hope that all-natural solutions may become more popular and credible in the near future.