From OncoLog, November 2004, Vol. 49, No. 11
In Brief: Research News from the Laboratories and Clinics at M. D. Anderson
Herceptin Boosts Response Rates in Breast Cancer
Adding trastuzumab (Herceptin) to presurgery chemotherapy treatment dramatically shrinks breast tumors in women with early-stage, HER-2-positive breast cancer, according to recent research at M. D. Anderson Cancer Center. Studies showed that the addition of Herceptin to the treatment regimen completely eradicated tumors in twice as many women as with chemotherapy alone (65% versus 26%).
About 25% to 30% of all breast cancer patients have tumors that are HER-2 positive, a marker that can signal a poorer prognosis due to increased risk of recurrence and decreased sensitivity to chemotherapy, said Aman Buzdar, M.D., professor in the Department of Breast Medical Oncology. “This is a significant stride in treating women with confined breast tumors who have tested positive for the HER-2 gene,” said Buzdar.
According to Dr. Buzdar, even though most of the breast tumors either virtually disappeared or shrank dramatically with the presurgery chemotherapy and Herceptin treatment, the breast still had to be treated surgically. Dr. Buzdar said the research team will look more closely at the effect the treatment may have on the type of surgery necessary after chemotherapy.
New Blood Test Predicts Breast Cancer Prognosis
Women with advanced breast cancer who have more than five circulating tumor cells in the blood may have a more dangerous form of the disease, according to a recent M. D. Anderson-led study published in the New England Journal of Medicine.
The findings could lead to more tailored treatments that would spare some women from the most potent chemotherapy or, conversely, recognize which patients need more aggressive therapy at the start of treatment, said the study’s lead author, Massimo Cristofanilli, M.D., associate professor in the Department of Breast Medical Oncology.
“This is the first time that we can actually stratify metastatic breast cancer patients based on their risk,” said Dr. Cristofanilli. New technology makes it possible to reliably isolate circulating tumor cells in the bloodstream with a blood test. This study found that the presence of cancer cells in the blood predicted prognosis more accurately than did the site of metastatic disease or the presence of estrogen receptors on the tumor cells.
“If we can discover in a newly diagnosed patient that tumor cells are already in the blood, both patient and physician would be aware that we are dealing with a more aggressive cancer that requires more aggressive treatment early on,” Dr. Cristofanilli said.
Biologic Drug Effective in Rare Leukemia
A biologic agent, Lipo-ATRA, appears to be as effective as chemotherapy in some patients with a rare form of leukemia, but without the risks and negative side effects of traditional chemotherapy.
Researchers showed that approximately one third of patients with acute promyelocytic leukemia (APL) can achieve long-term, disease-free remission with the drug, a finding that opens the door to the development of biologic agents for more common forms of leukemia.
“This is the first time we have seen patients with an acute leukemia potentially cured without use of chemotherapy,” said the study’s principal investigator, Elihu Estey, M.D., a professor in the Department of Leukemia at M. D. Anderson. Traditional treatment of APL combines the chemotherapy drug idarubicin with orally administered ATRA (all-trans retinoic acid), a form of vitamin A. Realizing that little of the vitamin A is absorbed when swallowed, M. D. Anderson researchers worked to find a more effective way to deliver ATRA.
The solution involved encasing ATRA in liposomes and injecting it so that it is not metabolized and stays longer in tissues. The approach was effective—of the 34 patients who received Lipo-ATRA, 10 remain in remission for an average of five years, despite never receiving chemotherapy.
Novel Agent Combination Shrinks Lung Tumors
A combination of two new agents shows promise in treating lung cancer, according to studies at M. D. Anderson. The agents have shown little benefit in treating lung cancer, but they had a substantial impact when used individually in low doses.
In a study published in the October 20 issue of the Journal of the National Cancer Institute, researchers tested an experimental targeted therapy, the farnesyltransferase inhibitor lonafarnib (also known as SCH66336) and the insulin-like growth factor binding protein-3 (IGFBP-3), in mice implanted with human lung tumors. The combined treatment shrank tumors to 45% the size of those in untreated mice. The treatment worked even in low doses and did not cause measurable side effects in the mice.
“Together these agents work on the pathway that is critical for the survival of a cancer cell,” said Ho-Young Lee, Ph.D., assistant professor in the Department of Thoracic/Head & Neck Medical Oncology Research and lead author of the study. Scientists from the U.S. Food and Drug Administration and Emory University also participated. Clinical trials are under development.
For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
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