Paclitaxel, carboplatin and trastuzumab demonstrate better survival, response and tolerability by HER 2+ metastatic breast cancer patients

Thursday, December 04, 2003

Women with metastatic breast cancer overexpressing human epidermal growth factor receptor 2 (HER2) have a significantly higher response rate and survival to a new, well-tolerated combination of therapy.

That is the conclusion of a study presented today by North Central Cancer Treatment Group (NCCTG) investigator Dr. Edith Perez at the 26th annual San Antonio Breast Cancer Symposium. Perez presented a final report on the response and toxicity data on all 91 patients enrolled in the study, NCCTG N98-32-52.

"This study will serve as the platform for other trials to further improve the ultimate outcome for patients," says Perez, the study's principal investigator. Perez is director of the Cancer Clinical Study Unit and Breast Cancer Program at Mayo Clinic in Jacksonville, Fla., and chair of the NCCTG Breast Committee.

She says a previous study, reported by Dr. Nicholas Robert at the 2002 San Antonio Breast Cancer Symposium, demonstrated the benefit of adding carboplatin to paclitaxel/trastuzumab for treating patients with HER2-positive breast cancer. "The value of our study is that it looked at adding a third effective drug ¯ carboplatin — to create a combination of paclitaxel, carboplatin and trastuzumab," Perez says. "We can significantly ameliorate toxicity while maintaining a high level of efficacy. In other words, patients can achieve good benefit from the tumor standpoint, and they have very few problems with low blood counts and peripheral neuropathy.

"In my opinion, this is really a breakthrough," Perez says. "We're always looking at novel drugs, but one of the most important avenues of research that can benefit patients today is to find out how to best use the agents we already have available."

In this randomized, phase II study, supported by the National Cancer Institute and the Breast Cancer Research Foundation, one group of women received paclitaxel, carboplatin and trastuzumab every three weeks up to eight times in the absence of disease progression or unacceptable toxicity. This group of patients then received trastuzumab every three weeks until disease progression.

Women in the second group received the combination on a weekly schedule, followed by trastuzumab until disease progression. This schedule allowed for the least toxicity and was overall more effective than the every three-week schedule. Women with HER2 overexpressing metastatic breast cancer can be optimally treated with this weekly schedule and combination.

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