Update on Her2 Positive Breast Cancer
The discovery of herceptin and its enormous value in the treatment of Her2 positive breast cancers has been one of the great success stories of cancer medicine. As one of my doctors has said: "This has leveled the playing field."
Here is a quote from a recent update by Dr Eric Winer of DFCI in Boston:
Update on HER2 Positive Breast Cancer (Dr. Eric Winer, July 2009)
Approximately 20 percent of women with breast cancer have what is called HER2 positive disease. In these tumors, there are extra copies of the HER2 gene in the nucleus of the cancer cell and, as a result, excess HER2 protein on the surface of the cancer cell. The HER2 proteins on the surface of the cancer cell interact with each other and with other proteins, and when these interactions occur, they cause the cancer cell to behave in a more aggressive manner. In particular, the HER2 positive cell tends to divide more rapidly, invades surrounding tissue and spreads to other parts of the body (that is, metastasizes). It is important to understand there have always many women with HER2 positive breast cancer who did well with the standard treatments. However, we have known for some time that women with HER2 positive breast are at increased risk of having a recurrence if treated with standard treatment consisting of surgery, radiation, chemotherapy and hormonal therapy.
The drug Herceptin, which is a monoclonal antibody, has changed the picture quite dramatically for women with HER2 positive breast cancer. Among women with advanced breast cancer, Herceptin shrinks tumors, slows the pace of the illness and has been shown to extend women's lives. For some women with advanced or metastatic breast cancer, the impact of Herceptin has been huge, but for others it has been more modest. Since 2005, we have known that administering Herceptin with chemotherapy helps to prevent recurrences of breast cancer in women with stage 1-3 breast cancer, and Herceptin has become part of adjuvant therapy for almost all women with HER2 positive breast cancer other than those who have very, very small tumors and negative lymph nodes.
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