New 'smart' breast cancer drug gives an extra six months of life and stops loss of hair

A new ‘smart’ drug for breast cancer extends women’s lives by six months while reducing toxic side effects including hair loss.

Campaigners claim the drug offers a ‘precious lifeline’ for women with the most aggressive form of the disease, who have tried other treatments.

Known as T-DM1, it combines the ‘wonder’ drug Herceptin with a potent chemotherapy agent.

T-DM1 is designed to seek out and destroy cancerous cells while sparing healthy tissue from unnecessary damage.

Results from a major trial show the drug prolonged the lives of patients with advanced HER2-positive breast cancer by 30.9 months compared with 25.1 months on standard therapy. 

Patients on T-DM1 had fewer, less severe side effects and reported a better quality of life.

The results were released yesterday at the European Society for Medical Oncology in Vienna, Austria.

Around 10,000 British women have HER-2 positive breast cancer diagnosed each year – about one in five of those affected.

Paul Ellis, professor of cancer medicine at King’s College London, said the trial results were remarkable in patients with advanced  disease who had relapsed on existing treatment. 

‘HER-2 positive breast cancer is very aggressive and once it progresses to the “advanced” stage it becomes very difficult to treat,’ he said. 

‘These results are truly outstanding and will positively alter the outlook and outcomes for patients.’

Professor Ellis said the drug was possibly the biggest advance since Herceptin was licensed for use in 2000. 

‘T-DM1 contains an extremely potent form of chemotherapy that’s been around 20 years which we haven’t been able to use before because it’s so toxic,’ he said.

‘Clever new technology has allowed these two older drugs to be linked so that the chemotherapy  is not released until it reaches  the target.

‘Drugs used at this stage of the disease often make women feel worse, but the beauty of this treatment is that it costs women fewer side effects such as hair loss and improves their quality of life.’

The international trial recruited 991 patients, including mother-of-two Emma Barnes, 36, who has been battling HER-2 positive breast cancer for nine years.

She joined the trial in May 2010 at the Christie Hospital Manchester after developing a liver tumour and has been having infusions of T-DM1 every three weeks. 

Although she became resistant to Herceptin after five years of treatment, the new drug has stopped any new secondary tumours.

BREAST CANCER RATES SOAR SINCE 1971

Breast cancer rates have increased by 90 per cent in the last four decades, figures suggest.

In 1971, there were 66 cases for every 100,000 women in England but by 2010 the rate had soared to 126 per 100,000, figures from the Office for National Statistics (ONS) suggest.

But the number of women dying from the disease has steadily declined since screening was introduced in 1987.

Charity Breast Cancer UK called on the Government to take action to reduce exposure to cancer-causing chemicals.

Clare Dimmer, chair of Breast Cancer UK, said: 'This shocking increase in breast cancer rates over just one generation underlines how vital it is that all the root causes of breast cancer are fully explored.

'Whilst death rates from breast cancer have thankfully decreased, still more and more of us are getting the disease. This epidemic is clearly not down to genetics and lifestyle choices alone.

'Breast Cancer UK calls on the Government to finally start tackling the growing health risk associated with our exposure to hazardous chemicals, such as Bisphenol A, that have been scientifically linked to breast cancer as well as many other diseases, and to take action to ban them.'

The ONS said that in 2010, 41,259 new cases were diagnosed, 731 more than 2009.

Breast cancer is the most common type of cancer in English women and in 2011 more than 9,700 women died from the disease.

‘I’m doing most things that I want to do,’ she said. 

‘My husband Garry has been amazing, and the children, but I think the drug’s been fantastic.’

She has experienced minor side effects but says it’s worth it. ‘I’ve got no evidence of disease at the moment,’ she added. 

‘I hope that every woman who needs this drug will eventually be able to get it.’

T-DM1 seeks out and destroys cancerous cells in a two-stage attack. It attaches to the tumour cell and blocks signals that encourage the cancer to spread.

Then it breaches the outer defences and releases chemotherapy to destroy it from within. This spares healthy tissue from unnecessary damage.

The cancer’s return is also delayed and side effects from chemotherapy such as diarrhoea and hair loss are significantly reduced.

Professor Ellis, who also works at Guy’s Hospital, London, said around 1,000 women a year would benefit from the drug in the UK after relapsing.

But eventually it might be used before the disease spread possibly replacing current treatment using Herceptin and chemotherapy as separate agents. 

It was possible the technology could be effective in treating other types of tumour.

The drug’s manufacturer, Roche, is applying for a licence in Europe, which could mean it is available for patients before the end of 2013. The price is not yet known.

Baroness Morgan, chief executive of the research charity Breast  Cancer Campaign, said: ‘This “smart” drug could be a precious lifeline for women with HER2- positive advanced breast cancer who currently have limited treatment options. We hope it will be made available to women as early as possible.’

Carolyn Rogers, senior clinical nurse specialist at another charity, Breast Cancer Care, said: ‘The trial evaluates a new way of combining chemotherapy and targeted therapy in one agent which could help delay the progression of secondary breast cancer as well as reduce the likelihood of some of the very unpleasant side effects that are associated with chemotherapy.’

New Breast Cancer Clues Found In Gene Analysis

Scientists reported Sunday that they have completed a major analysis of the genetics of breast cancer, finding four major classes of the disease. They hope their work will lead to more effective treatments, perhaps with some drugs already in use.

The new finding offers hints that one type of breast cancer might be vulnerable to drugs that already work against ovarian cancer.

The study, published online Sunday by the journal Nature, is the latest example of research into the biological details of tumors, rather than focusing primarily on where cancer arises in the body.

The hope is that such research can reveal cancer’s genetic weaknesses for better drug targeting.

“With this study, we’re one giant step closer to understanding the genetic origins of the four major subtypes of breast cancer,” Dr. Matthew Ellis of the Washington University School of Medicine said in a statement. He is a co-leader of the research.

“Now we can investigate which drugs work best for patients based on the genetic profiles of their tumors,” he said.

The researchers analyzed DNA of breast cancer tumors from 825 patients, looking for abnormalities. Altogether, they reported, breast cancers appear to fall into four main classes when viewed in this way.

One class showed similarities to ovarian cancers, suggesting it may be driven by similar biological developments.

“It’s clear they are genetically more similar to ovarian tumors than to other breast cancers,” Ellis said. “Whether they can be treated the same way is an intriguing possibility that needs to be explored.”

The report is the latest from the Cancer Genome Atlas, a federally funded project that has produced similar analyses for brain, colorectal, lung, and ovarian cancers.

Fatigue after breast cancer overestimated

Few women who were treated for breast cancer feel persistent fatigue a year later, an Australian study suggests.

Disabling fatigue is common after many cancer treatments, with some studies estimating up to half of women feeling that way for months after treatment ends.

Researchers in Australia set out to test how common cancer-related fatigue actually is among women with early-stage breast cancer who had surgery along with treatment such as radiation or chemotherapy.
Breast cancer survivor Hastine Reese, 50, said exercising helped lift her mood after treatment. (David Goldman/Associated Press)
"The good news is that the vast majority of women who have undergone cancer treatment either never experience ongoing debilitating fatigue in the weeks and months after treatment ends or if they do, it passes relatively quickly," said Professor David Goldstein of the University of New South Wales in Sydney.

Cancer-related fatigue is common but people can be reassured that in most cases, it is not debilitating in the long-term, he added in a release.

For the study in April's issue of the Journal of Clinical Oncology, Goldstein and his colleagues followed 218 women for five years.

Tumour size a factor

The breast cancer patients were observed and questioned every three months for a year after treatment and then again at five years.

The researchers used a strict definition of confirmed fatigue that ruled out causes such as anemia or thyroid disease.

Investigators recorded both physical and psychological aspects, such as pain, sleep and mood.

An oncologist and in most cases a psychiatrist reviewed the persistent cases of fatigue.

Large tumour size was the only predictor of persistent cancer-related fatigue, the researchers said.

Exercise benefits

The rate for cancer-related fatigue fell steadily from 31 per cent at the end of treatment to 11 per cent at six months and six per cent at one year.

The small minority of women who experience ongoing fatigue need to be identified early so resources can directed to them, the study's authors concluded.

Exercise may be a key way of helping more cancer survivors to manage, they suggested.

New guidelines released this week by the American Cancer Society urge doctors to talk to cancer patients about eating right, exercising and slimming down if needed.

Hastine Reese, a breast cancer survivor, said she began to exercise because her husband pushed her to. Besides being good for her health, he thought it might help pull her out of the depression that followed her diagnosis and double-mastectomy.

"When you're first diagnosed with cancer, you go into a dark place," said Reese, as she finished a one-hour exercise class this week at DeKalb Medical Center in Decatur, Ga.

Exercise has helped her mood. "I'm coming into the light, and it's getting brighter and brighter," she said.

The study was funded by the Susan G. Komen Foundation and Ramaciotti Foundation.

Study finds new type of mutation in breast cancer

Oncologists may now have a better way to classify – and ultimately treat – breast cancer.

Researchers out of the Mayo Clinic in Jacksonville, Fla., have uncovered a new class of molecular mutations in breast cancer tissue – a discovery that could lead to a better understanding of how to provide individualistic treatment for the disease.

The mutations are called fusion transcripts and are formed when chromosomes break apart and fuse together to become fusion genes.  Fusion genes – comprised of DNA – subsequently produce fusion transcripts (RNA).

“We found 131 fusion transcripts, but what made it more interesting was that 45 of those transcripts were seen in multiple specimens,” said Dr. Edith Perez, deputy director of the Mayo Clinic Comprehensive Cancer Center in Florida and senior investigator for the study.  “When we looked at the expression of these noble fusion transcripts, they appeared to be subtype-specific.

Currently, oncologists are aware of three basic categories of breast cancer – estrogen-receptor (ER)-positive, HER2-positive, and triple negative.

After collecting cancer cells from 24 different breast cancer tumors and comparing them to non-cancer cells, Perez and her team found that certain types of fusion transcripts would appear multiple times in the same cancer subtypes.   For example, one kind of transcript would appear over and over in triple negative cancer cells, while another kind of transcript would appear repeatedly in HER2-positive cancer cells – making them subtype-specific.

By observing this repetition of fusion transcripts, the team potentially identified the fused RNA as biomarkers that can be used to help treat the disease in the future.

“These transcripts represent a previously underappreciated class of genetic features that may have considerable potential as biomarkers or therapeutic markers in breast cancer,” Perez said.

Fusion transcripts are typically formed in cancer cells and have recently become helpful biomarkers for common blood cancers such as leukemia and lymphoma.  This discovery is one of the first to reveal fusion transcripts in solid cancers – and the first to reveal transcripts in breast cancer tissue.

Read more: http://www.foxnews.com/health/2012/04/13/study-finds-new-type-mutation-in-breast-cancer/#ixzz1s9LuRpDf