Photo: Corbis
Doctors
said the new two-pronged technique for breast cancer could spare
thousands of women from grueling chemotherapy treatment
'game-changing' for aggressive breast cancer treatment Doctors combined two existing cancer drugs - Tyverb and Herceptin
Cancer cells stopped producing in 87 per cent of the women during trial
Tumours were found to 'completely vanish' in 11 per cent of patients
'In combination, the drugs cost just under $2,200 (£1,500), for an 11-day course'
...lots of progress on the cancer treatment front, spread the news
A new treatment for breast cancer has completely eradicated tumors in just 11 days.
Doctors today described the unexpected
results as ‘staggering’ – and said the new two-pronged technique could
spare thousands of women from grueling chemotherapy.
The UK team, announcing their results
at the European Breast Cancer Conference in Amsterdam, said they had
never seen breast patients respond so quickly to a cancer treatment.
Women who were newly diagnosed with an aggressive form of breast cancer were given the therapy at 23 UK hospitals.
Of the participants in the trial the
vast majority - 87 per cent – responded to the treatment, with tests
showing that the cancer had stopped producing more cells.
But for some women the results were more dramatic.
In 11 per cent the tumors had
completely vanished, to the surprise of surgeons, and for another 17
per cent they had significantly shrunk.
Doctors combined two existing cancer drugs - Tyverb and Herceptin – and gave them to women as soon as they were diagnosed.
The team, led by the University of
Manchester and the Institute of Cancer Research in London, had
initially aimed simply to shrink tumors in the few days before
surgery.
But when the surgeons tried to remove
the lumps – which had measured up to 3cm wide just a few days earlier -
they found that in some women the tumors had already vanished.
Study leader Professor Nigel Bundred, a
cancer surgeon in Manchester, said: ‘For solid tumors to disappear in
11 days is unheard of. These are mind-boggling results.’
And Professor David Cameron, oncologist at Edinburgh University, said: ‘It was only when the pathologists were scratching around in the lab saying, “where is the tumour?”, that it became apparent that there was no tumour at all.’
The experts said that because the trial
was relatively small – involving 257 women of whom 66 took the
combination treatment – further tests are needed before they consider
rolling the treatment out more widely.
"These results are so staggering that we will have to run another trial to prove that they are generalisable" - Professor Nigel Bundred, University of Manchester
But, while remaining cautious, they struggled to contain their excitement at the early results
Professor Bundred said: ‘These results
are so staggering that we will have to run another trial to prove that
they are generalisable.
‘But it is clear what has happened – we
are pretty certain that we are not only getting tumour disappearance –
we are getting an immune response as well.’
The treatment was given to women with
the HER2-positive form of breast cancer, which affects around 8,000
women in Britain every year.
Herceptin, which is delivered via a
drip, is often used alongside chemotherapy to treat women with this
form of the disease – but usually only after surgery in a bid to stop
the cancer returning.
Tyverb, which is also known as
Lapatinib, is a pill used for women with advanced breast cancer,
usually when other treatments have failed and the disease has spread to
other parts of the body.
By giving the combination right at the
start, as soon as a woman was diagnosed, the researchers found they
could eradicate the disease at the very beginning.
Women will still have to have surgery,
to make sure no cancer cells are left - but the doctors hope it will
mean they don't have to have chemotherapy afterwards.
In combination, the drugs cost just
under £1,500 for an 11-day course – and because Tyverb is nearing the
end of its patent the cost is expected to plummet.
Professor Bundred said: ‘A large chunk
of evolution is not about suddenly finding a new drug, it is about
finding a new way to use the drugs we already have in a new way.
‘We have found a group of people who respond exquisitely well.’
Professor Judith Bliss, of the
Institute of Cancer Research in London, said: ‘We set up the trial to
see whether we could see which patients responded from a biological
point of view.
‘But to see that we couldn’t even find the tumor left at all in some patients was very surprising.’
Cancer
charities welcomed the findings – and called for more research so that
the benefits can be quickly rolled out to patients.
"For some HER2 positive breast
cancer patients the effect of this drug combination will be amazing,
and mean they can avoid chemotherapy and its grueling side effects
completely" - Samia al Qadhi, chief executive, Breast Cancer Care
Samia al Qadhi, chief executive at
Breast Cancer Care, said: ‘The astonishing findings in this study show
that combining these two drugs has the potential to shrink HER2
positive breast cancer in just 11 days.
‘For some HER2 positive breast cancer
patients the effect of this drug combination will be amazing, and mean
they can avoid chemotherapy and its gruelling side effects completely.
‘For others, their tumours may not shrink, but doctors will know either way very quickly, giving them the ability to rapidly decide on further treatment.
‘Although an early study, this has game changing potential.
Baroness Delyth Morgan, chief executive
at Breast Cancer Now, added: ‘We hope this particularly impressive
combination trial will serve as a stepping stone to an era of more
personalised treatment for HER2 positive breast cancer.
‘Such a rapid response before surgery
could soon give doctors the unprecedented ability to identify women
responding so well to combined HER2-targeting drugs that they would not
need gruelling chemotherapy.
‘To confirm these hopes, we’ll now need
to see the results replicated in larger trials and to understand how
such a positive response to combined HER2-targeted drugs before surgery
– and the avoidance of chemotherapy – could impact on survival.’
Professor Arnie Purushotham of Cancer
Research UK, which funded the study, said: ‘These results are very
promising if they stand up in the long run and could be the starting
step of finding a new way to treat HER2 positive breast cancers.
‘This could mean some women can avoid
chemotherapy after their surgery - sparing them the side-effects and
giving them a better quality of life.’
HOW DOES THE TREATMENT WORK?
Some 8,000 of the 50,000 women
diagnosed with breast cancer in Britain every year have the HER2
positive form of the disease, which tends to be more aggressive.
These tumours are more deadly, because
they have HER2 (human epidermal growth factor) proteins on the surface
of normal breast cells, which accelerates the growth of cancers
Combining the treatment was found to stop cancer cells reproducing and shrunk some women's tumours completely
The outcomes for women with HER2 positive cancer in the past were very poor – with many women seeing
their tumours returning soon after surgery. But a decade ago Herceptin –
the first gene-targeted ‘wonder drug’ – changed their lives.
Given after surgery, and alongside chemotherapy, Herceptin boosted five-year survival from 66 per cent to 95 per cent.
Now, a new approach to treatment could
improve survival rates even further, while removing the need for months
and months of grueling chemotherapy.
The new approach takes Herceptin and
combines it with another powerful drug called Tyverb – and gives it to
women in the very first days after they are diagnosed with breast
cancer.
One drug attacks cancer cells from the
outside, and the other burrows inside cells and attacks it from the
inside. Doctors think this twin attack provides a ‘total block’ –
stopping cancer cells dividing and rapidly killing them off.
Early trials showed that the vast majority of women responded to the treatment, and for one in ten women their tumours simply vanished within 11 days.
Women given the combination will still
need surgery to check that the tumour has disappeared, and to remove
any remaining cells. But doctors hope that they will not need to
undergo further treatments.
Herceptin, given via a drip, latches on
to the surface of the cell, stopping the HER2 protein working. Tyverb
is given as a pill, working inside the cancer cells and blocking the
HER2 signals that make the cells grow.
In combination, the drugs also appear to boost the body’s immune response.
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