New Adjunctive Regimens for Breast Cancer Treatment Are Under Study

ORLANDO—“Adjuvant therapy for breast cancer can be improved through the use of new agents, such as taxanes,” Edith A. Perez, MD, said at the Joint Cancer Conference of the Florida Universities. Dr. Perez is associate professor of medicine, Mayo Medical School, and director of the Clinical Investigation & Breast Cancer Program, Mayo Clinic, Jacksonville, Florida.

With metastatic breast cancer, the data have been accumulated showing that combinations such as epirubicin (Ellence) and a taxane achieve high activity. “We now feel that it’s reasonable to move these combinations into clinical trials in the adjuvant setting,” Dr. Perez said in an interview with ONI.

Epirubicin became available in the United States this past fall, based on a number of Canadian and European trials supporting its use. “We want to bring this innovative combination to the United States and are now engaged in developing a study to support it,” Dr. Perez said.

Other studies in which she is involved are exploring the value of various dosing regimens. One study is examining the use of paclitaxel (Taxol) or docetaxel (Taxotere) at a regular weekly dosing regimen vs 3 weeks on and 1 week off. “This may increase tolerability while producing the same response rate,” she said.

Another study has the goal of optimizing the schedule of chemotherapy combined with the anti-HER-2/neu monoclonal antibody trastuzumab (Herceptin). In this study, patients in one group will receive chemotherapy every 3 weeks and Herceptin weekly. Patients in the other group will undergo weekly chemotherapy and weekly Herceptin.

Yet another study that will begin soon will investigate whether patients with a low degree of HER-2/neu expression can benefit from Herceptin therapy. In that study, all the patients will receive chemotherapy but half will get Herceptin and half will not. Herceptin has already been shown to be effective in the treatment of patients with a high degree of HER-2/neu expression, Dr. Perez said.