A phase II study found that the use of trastuzumab (Herceptin)
in combination with docetaxel (Taxotere) and cisplatin shrank breast tumors
so significantly that locally invasive cancers became undetectable in 1 of 4
women (26%) who participated in the study. Half of all women (50%) were node-negative
by the time of surgery, after receiving treatment with the novel combination.
Judith Hurley, MD, a consultant at the Taylor Breast Health Center at Jackson
Memorial Hospital, assistant professor of medicine at the University of Miami
(UM), a member of the UM/Sylvester breast cancer site-based disease group, and
lead investigator of the study, presented the results at a poster session at the
38th annual meeting of the American Society of Clinical Oncology (ASCO).
This phase II clinical trial incorporated trastuzumab into a neoadjuvant
regimen. Approximately 20% to 30% of women with breast cancer have extra copies
of the HER2/neu protein in the membrane of their breast cancer cells. The
presence of many such proteins in the cell membrane is associated with a poorer
prognosis and may account for as many as 60,000 breast cancer cases a year.
Trastuzumab blocks the growth receptors on the surface of the cell.
Both docetaxel and cisplatin are known to be synergistic with trastuzumab in
vitro. The combination of trastuzumab with docetaxel and cisplatin in the
neoadjuvant setting was designed to take advantage of this synergy in hopes of
improving response rates and ultimately survival in women with breast cancer.
"This regimen proved to be highly active, yielding an unusually high rate
of tumor disappearance, which hopefully will translate to an improvement in
survival," said Dr. Hurley