Scientists make 'exciting' advancement in certain breast cancer drugs

Two new drugs for advanced HER2-positive breast cancer were tested in separate studies, and scientists say they've made progress in the development of new tr...

Posted: Dec 17, 2019 8:29 AM

Two new drugs for advanced HER2-positive breast cancer were tested in separate studies, and scientists say they've made progress in the development of new treatment options.

This type of breast cancer tests positive for higher levels of a protein called HER2.

One study, published in the New England Journal of Medicine last week, found that adding the experimental drug tucatinib to a chemotherapy regimen consisting of the drugs trastuzumab and capecitabine could improve survival for adults with advanced HER2-positive metastatic breast cancer.

The other study, also published in the New England Journal of Medicine last week, found that the experimental drug conjugate called trastuzumab deruxtecan was able to substantially reduce tumor activity in patients with HER2-positive metastatic breast cancer.

"Both studies are evaluating new drugs for HER2-positive breast cancer, which represents about 15% to 20% of all breast cancers," said Dr. Eric Winer, chief of the division of breast oncology at Dana-Farber Cancer Institute in Boston and professor of medicine at Harvard Medical School, who was the senior author of the tucatinib study.

"What's so exciting is we have developed multiple new drugs for HER2-positive breast cancer -- we have new drugs for all subtypes of breast cancer -- but the changes are most dramatic in the setting of HER2-positive breast cancer," Winer said.

"It is the single area in breast cancer where we have made the most dramatic progress and continue to," he said. "For individuals with advanced breast cancer we can individualize therapy more than in the past; it is no longer one size fits all."

The tucatinib study: 'It was pretty well tolerated'

The tucatinib study included 613 patients who previously underwent chemotherapy for HER2-positive metastatic breast cancer by taking the drugs trastuzumab, pertuzumab and trastuzumab emtansine -- but that treatment approach had stopped working for the patients.

For the study, the patients were randomly assigned to either the drug tucatinib or a placebo and received chemotherapy with the drugs trastuzumab and capecitabine.

The researchers found that in the first year of treatment, 33.1% of patients in the tucatinib group did not see their cancer progress compared with 12.3% of patients in the placebo group.

The researchers also found that overall survival two years after starting treatment was 44.9% among patients in the tucatinib group and 26.6% among those in the placebo group.

Side effects of the tucatinib treatment that emerged in the study included the risks of diarrhea and elevated levels of an enzyme in the body called aminotransferase.

"But in general it was pretty well tolerated," Winer said.

Next year, the biotechnology company Seattle Genetics, which develops tucatinib, plans to submit a new drug application to the US Food and Drug Administration and an application to the European Medicines Agency with the goal of bringing this new medicine to the public, Dr. Roger Dansey, chief medical officer at the company, said in a press release on Wednesday.

"Continued innovation to bring new therapies for the treatment of metastatic HER2-positive breast cancer is urgently needed, and we are encouraged by the impressive clinical activity demonstrated with the addition of tucatinib to trastuzumab and capecitabine," he said in part.

The trastuzumab deruxtecan study: 'I am cautiously optimistic'

The trastuzumab deruxtecan study included 184 patients who had already undergone multiple prior treatments for HER2-positive breast cancer. The patients were given the recommended dose of trastuzumab deruxtecan at 5.4 mg per kilogram of body weight.

The researchers found that the patients saw no further progression of their cancer for a median of 16.4 months and that the cancer in 60.9% of the patients shrunk by at least 50% in response to the treatment. However, the treatment came with some side effects, including nausea, myelosuppression -- the decline of bone marrow activity -- and interstitial lung disease.

Overall, "it is rare that a drug has effects on women heavily pretreated," said Dr. Otis Brawley, Bloomberg Distinguished Professor of oncology and epidemiology at Johns Hopkins University, who was not involved in the new study.

"I am cautiously optimistic," he said, but added that more research is needed to determine whether trastuzumab deruxtecan could help patients live longer.

Dr. Ian Krop, a principal investigator of the study and associate chief of the division of breast oncology at Dana-Farber Cancer Institute in Boston, called the research results "striking" in a press release on Wednesday.

"These results are particularly striking as trastuzumab deruxtecan prompted a high level of durable tumor reduction among patients, the majority of whom had exhausted most if not all standard therapies for HER2-metastatic breast cancer," he said. "We are excited by these results and their potential to help patients with this advanced stage of breast cancer."

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 320292

Reported Deaths: 7390
CountyCasesDeaths
DeSoto22299271
Hinds20782424
Harrison18455317
Rankin13933282
Jackson13740249
Madison10276225
Lee10068176
Jones8475167
Forrest7845153
Lauderdale7263242
Lowndes6524150
Lamar636688
Lafayette6315121
Washington5427138
Bolivar4842133
Panola4671110
Oktibbeha466398
Pearl River4610148
Marshall4576105
Warren4440121
Pontotoc426173
Monroe4163136
Union415977
Neshoba4066180
Lincoln4009113
Hancock387687
Leflore3516125
Tate342586
Sunflower339491
Pike3374111
Alcorn327474
Scott320374
Yazoo314771
Adams308586
Itawamba305178
Copiah299966
Coahoma299084
Simpson298689
Tippah292468
Prentiss284461
Leake272474
Marion271480
Covington267283
Wayne264842
Grenada264087
George252451
Newton249064
Tishomingo232469
Winston230382
Jasper222148
Attala215173
Chickasaw210759
Holmes190574
Stone188833
Clay187954
Tallahatchie180041
Clarke178980
Calhoun174232
Yalobusha167940
Smith164134
Walthall135547
Greene131934
Lawrence131424
Montgomery128943
Noxubee128034
Perry127538
Amite126542
Carroll122330
Webster115132
Jefferson Davis108534
Tunica108127
Claiborne103130
Benton102325
Humphreys97533
Kemper96729
Franklin85023
Quitman82316
Choctaw79218
Wilkinson69632
Jefferson66328
Sharkey50917
Issaquena1696
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Alabama Coronavirus Cases

Cases: 549394

Reported Deaths: 11328
CountyCasesDeaths
Jefferson810851571
Mobile42180832
Madison35733524
Tuscaloosa26186460
Shelby25638255
Montgomery25103615
Baldwin21921314
Lee16301176
Calhoun14725329
Morgan14650286
Etowah14192364
Marshall12465230
Houston10798289
Elmore10302214
Limestone10191157
St. Clair10166251
Cullman9975201
Lauderdale9621250
DeKalb8978190
Talladega8467184
Walker7351281
Autauga7244113
Jackson6993113
Blount6957139
Colbert6418140
Coffee5650128
Dale4931116
Russell455241
Chilton4476116
Franklin432082
Covington4283123
Tallapoosa4137155
Escambia402380
Chambers3731124
Dallas3609158
Clarke353361
Marion3264107
Pike314878
Lawrence3135100
Winston283672
Bibb268664
Geneva258782
Marengo250566
Pickens237062
Barbour234460
Hale227078
Butler225071
Fayette219763
Henry194844
Randolph187744
Cherokee187545
Monroe181041
Washington170639
Macon163051
Clay160159
Crenshaw156157
Cleburne153744
Lamar147237
Lowndes142154
Wilcox126830
Bullock124642
Conecuh113830
Coosa112129
Perry108826
Sumter106032
Greene93734
Choctaw62125
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