New Targeted Therapies for Breast Cancer

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By Jennifer Litton M.D., from ASCO 2009

Litton2.jpgThe 2009 ASCO annual meeting continues to highlight personalizing care for breast cancer patients.  By improving our knowledge of the different pathways within a tumor cell that are either enhanced or silenced, oncologists can tailor discussions regarding risk of recurrence and death.  Additionally, this knowledge is being used to guide oncologists in determining the best surgical and chemotherapy treatments for our patients.

For several decades in breast cancer care, treatments have been determined based on tumor hormone sensitivity for recommending the use of anti-estrogen treatments such as tamoxifen and the aromatase inhibitors.  With the identification of the HER-2/neu receptor, targeted agents such as trastuzumab, substantial strides in cure rates and survival were made.
At this year's annual meeting multiple new, targeted therapies are emerging in clinical trials.  Several new trials evaluating innovative anti-HER-2 therapies show promising results.  The new trastuzumab DM-1 compound combines the power of targeting HER2 receptors on the outside of tumor cells and then making the cell take that compound directly into the tumor cell where it releases a powerful tumor-killer directly into the tumor cell.  As the particular molecular changes in an individual's tumors are analyzed, this new generation of engineered drugs is being devised to maximize killing tumor cells and leaving healthy, unaffected cells alone.  This would hopefully translate into minimal side effects and maximum efficacy.  Other agents targeting HER2 or other HER family members are currently in large clinical trials with some preliminary results scheduled for release during this meeting.

 Tomorrow, during the plenary session, Dr. Joyce O'Shaugnessy will be presenting results from a study in metastatic breast cancer with a PARP inhibitor combined with gemcitabine and carboplatin.  This particular new class of anti-cancer drugs may specifically be effective in patients with known BRCA deleterious mutations and may play a part in multiple solid tumors.  We are also awaiting results, later in this meeting, of new molecular profiling studies that may help clinicians also tailor specific chemotherapy choices.

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