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Herceptin in Her2-positive Breast Cancer

Summary & Participants

Herceptin is a drug commonly used to treat metastatic breast cancer when it’s a type known as Her2 positive. What is this drug, and how does it work?

Medically Reviewed On: July 16, 2008

Webcast Transcript

ANNOUNCER: Between 20% and 30% percent of women with breast cancer have a type called HER2 or HER2/neu positive. HER2-positive breast cancer is more likely to recur and metastasize.

But if a woman has metastatic HER2-positive breast cancer, there are good treatments available, including a targeted therapy called Herceptin.

JOYCE O'SHAUGHNESSY, MD: Herceptin is a very, very important treatment for HER2-driven metastatic breast cancer. In fact, it is the cornerstone of treatment for HER2+ -positive metastatic breast cancer. . . . It dramatically increases the effectiveness of chemotherapy for women with HER2-positive+ metastatic breast cancer and dramatically improves the survival of women with metastatic breast cancer.

ANNOUNCER: Herceptin has been available only since 1998, for scientists have only recently understood how the HER2 protein can stimulate cancer growth.

MARY CIANFROCCA, DO: Herceptin is a monoclonal antibody that binds to the HER-2/neu receptors on the surface of the cell. When it binds to those receptors it effects affects the way the cell functions and causes the cell to die prematurely.

ANNOUNCER: Before this discovery, women being treated for metastatic breast cancer would generally receive chemotherapy, and, in some cases, hormonal therapies. Now, for women with HER2-positive cancer, Herceptin is usually added to a chemotherapy regimen. Studies have proven the value of this combination approach.

WILLIAM GRADISHAR, MD: In those trials, we identified a response rate of roughly 29%-30% in patients who got chemotherapy alone. That increased to 45% in patients who got the combination of chemotherapy and the Herceptin.

ANNOUNCER: Herceptin therapy does not require hospitalization. It's administered in a clinic, on a somewhat flexible schedule.

JOYCE O'SHAUGHNESSY, MD: Herceptin is given intravenously, either once a week or every three weeks; either one is fine. It can either be given by itself, it can be given with an anti-estrogen therapy, or it can be given with chemotherapy.

ANNOUNCER: Herceptin is generally a very well- tolerated drug.

MARY CIANFROCCA, DO: It's very uncommon for a woman to experience significant side effects, even after the first infusion of Herceptin. While theoretically it can cause joint pains, body aches, and low grade fever, it's actually very uncommon for women to experience that.

JOYCE O'SHAUGHNESSY, MD: Rarely, very rarely, a woman might have a slight allergic reaction initially . . . some flushing, you know, feeling red and, sweaty or something; that's very rare. We can easily prevent that by giving a little Benadryl first.

ANNOUNCER: One more serious but rare side-effect is a heart problem, so testing of heart function is important before and during therapy. And doctors have learned to avoid combining Herceptin with one particular chemotherapy drug.

JOYCE O'SHAUGHNESSY, MD: The chemotherapy agent that we do not combine with Herceptin is Adriamycin or a close cousin of it called Epirubicine, because we know, from clinical trials, that, if you combine those agents with Herceptin, it can lead to a high chance of heart damage and congestive heart failure.

ANNOUNCER: In addition to cardiac monitoring, women receiving Herceptin will be evaluated at regular intervals with CAT scans, PET scans or MRI's. These tests will help detect changes in tumor size in the organs where the cancer has metastasized.

WILLIAM GRADISHAR, MD: We generally monitor the effectiveness of therapy by repeating imaging studies roughly every two to three cycles of therapy, which may translate into an equivalent amount of time of two to three months. . . . That would tell us what the effectiveness of the treatment is.

ANNOUNCER: A small percentage of people with HER2-positive breast cancers will prove resistant to the therapy. But most patients respond to Herceptin, and do so without significant side effects.

As with several other cancers, a targeted therapy is proving valuable in the treatment of breast cancer. For metastatic disease, Herceptin is not a cure. But it's helping extend the lives of many women.