Novel Combination Reduces Tumors Before Surgery in Women With Breast Cancer

A phase II study found that the use of trastuzumab(Drug information on trastuzumab) (Herceptin) in combination with docetaxel(Drug information on docetaxel) (Taxotere) and cisplatin(Drug information on 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).

Neoadjuvant Regimen

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