- Doctors combined two existing cancer drugs – Tyverb and Herceptin
- Cancer cells stopped producing in 87 per cent of the women during trial
- Tumours were found to ‘completely vanish’ in 11 per cent of patients
- Charities called it ‘game-changing’ for aggressive breast cancer treatment
A new treatment for breast cancer has completely eradicated tumours in just 11 days. Doctors today described the unexpected results as ‘staggering’ – and said the new two-pronged technique could spare thousands of women from gruelling chemotherapy. The UK team, announcing their results at the European Breast Cancer Conference in Amsterdam, said they had never seen breast patients respond so quickly to a cancer treatment.
Women who were newly diagnosed with an aggressive form of breast cancer were given the therapy at 23 UK hospitals.
Of the participants in the trial the vast majority – 87 per cent – responded to the treatment, with tests showing that the cancer had stopped producing more cells. But for some women the results were more dramatic. In 11 per cent the tumours had completely vanished, to the surprise of surgeons, and for another 17 per cent they had significantly shrunk.
Doctors combined two existing cancer drugs – Tyverb and Herceptin – and gave them to women as soon as they were diagnosed.
The team, led by the University of Manchester and the Institute of Cancer Research in London, had initially aimed simply to shrink tumours in the few days before surgery. But when the surgeons tried to remove the lumps – which had measured up to 3cm wide just a few days earlier – they found that in some women the tumours had already vanished.
Study leader Professor Nigel Bundred, a cancer surgeon in Manchester, said: ‘For solid tumours to disappear in 11 days is unheard of. These are mind-boggling results.’
MALE SUFFERERS ‘GET THE WRONG TREATMENT’
Men with breast cancer are at a disadvantage and may be dying because they are treated in the same way as women, experts have warned.
Nearly 400 men are diagnosed with the disease each year in the UK and doctors have until now assumed the cancers are the same. But analysis of 1,500 male breast cancer patients from nine countries found key differences between their tumours and those of women.
The project, led by the Erasmus Medical Centre in Rotterdam, revealed that male breast cancers have different connective tissue, different cells, and are affected by the immune system in a different way. The discovery means that until now men may not have been treated in the best way.
Speaking at the European Breast Cancer Conference in Amsterdam yesterday, pathologist Dr Carolien van Deurzen said the results of the study could lead to ‘better treatment choices’ for male breast cancer patients in future.
Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: ‘This study… could change how decisions about the necessity of chemotherapy for certain male patients are made.’
And Professor David Cameron, oncologist at Edinburgh University, said: ‘It was only when the pathologists were scratching around in the lab saying, “where is the tumour?”, that it became apparent that there was no tumour at all.’
The experts said that because the trial was relatively small – involving 257 women of whom 66 took the combination treatment – further tests are needed before they consider rolling the treatment out more widely.
These results are so staggering that we will have to run another trial to prove that they are generalisable
Professor Nigel Bundred, University of Manchester
But, while remaining cautious, they struggled to contain their excitement at the early results.
Professor Bundred said: ‘These results are so staggering that we will have to run another trial to prove that they are generalisable.
‘But it is clear what has happened – we are pretty certain that we are not only getting tumour disappearance – we are getting an immune response as well.’
The treatment was given to women with the HER2-positive form of breast cancer, which affects around 8,000 women in Britain every year. Herceptin, which is delivered via a drip, is often used alongside chemotherapy to treat women with this form of the disease – but usually only after surgery in a bid to stop the cancer returning.
Tyverb, which is also known as Lapatinib, is a pill used for women with advanced breast cancer, usually when other treatments have failed and the disease has spread to other parts of the body. By giving the combination right at the start, as soon as a woman was diagnosed, the researchers found they could eradicate the disease at the very beginning.
Women will still have to have surgery, to make sure no cancer cells are left – but the doctors hope it will mean they don’t have to have chemotherapy afterwards. Two existing cancer drugs – Tyverb and Herceptin (above) – were given to women. It was found to halt the production of new cancer cells in 87 per cent of patients
In combination, the drugs cost just under £1,500 for an 11-day course – and because Tyverb is nearing the end of its patent the cost is expected to plummet. Professor Bundred said: ‘A large chunk of evolution is not about suddenly finding a new drug, it is about finding a new way to use the drugs we already have in a new way. ‘We have found a group of people who respond exquisitely well.’
Professor Judith Bliss, of the Institute of Cancer Research in London, said: ‘We set up the trial to see whether we could see which patients responded from a biological point of view.
‘But to see that we couldn’t even find the tumour left at all in some patients was very surprising.’ Cancer charities welcomed the findings – and called for more research so that the benefits can be quickly rolled out to patients.
For some HER2 positive breast cancer patients the effect of this drug combination will be amazing, and mean they can avoid chemotherapy and its gruelling side effects completely
Samia al Qadhi, chief executive, Breast Cancer Care
Samia al Qadhi, chief executive at Breast Cancer Care, said: ‘The astonishing findings in this study show that combining these two drugs has the potential to shrink HER2 positive breast cancer in just 11 days. ‘For some HER2 positive breast cancer patients the effect of this drug combination will be amazing, and mean they can avoid chemotherapy and its gruelling side effects completely.
‘For others, their tumours may not shrink, but doctors will know either way very quickly, giving them the ability to rapidly decide on further treatment.
‘Although an early study, this has game changing potential. Baroness Delyth Morgan, chief executive at Breast Cancer Now, added: ‘We hope this particularly impressive combination trial will serve as a stepping stone to an era of more personalised treatment for HER2 positive breast cancer.
‘Such a rapid response before surgery could soon give doctors the unprecedented ability to identify women responding so well to combined HER2-targeting drugs that they would not need gruelling chemotherapy. ‘To confirm these hopes, we’ll now need to see the results replicated in larger trials and to understand how such a positive response to combined HER2-targeted drugs before surgery – and the avoidance of chemotherapy – could impact on survival.’
Professor Arnie Purushotham of Cancer Research UK, which funded the study, said: ‘These results are very promising if they stand up in the long run and could be the starting step of finding a new way to treat HER2 positive breast cancers.
‘This could mean some women can avoid chemotherapy after their surgery – sparing them the side-effects and giving them a better quality of life.’
HOW DOES THE TREATMENT WORK?
Some 8,000 of the 50,000 women diagnosed with breast cancer in Britain every year have the HER2 positive form of the disease, which tends to be more aggressive. These tumours are more deadly, because they have HER2 (human epidermal growth factor) proteins on the surface of normal breast cells, which accelerates the growth of cancers. Combining the treatment was found to stop cancer cells reproducing and shrunk some women’s tumours completely
The outcomes for women with HER2 positve cancer in the past were very poor – with many women seeing their tumours returning soon after surgery. But a decade ago Herceptin – the first gene-targeted ‘wonder drug’ – changed their lives. Given after surgery, and alongside chemotherapy, Herceptin boosted five-year survival from 66 per cent to 95 per cent.
Now, a new approach to treatment could improve survival rates even further, while removing the need for months and months of gruelling chemotherapy. The new approach takes Herceptin and combines it with another powerful drug called Tyverb – and gives it to women in the very first days after they are diagnosed with breast cancer.
One drug attacks cancer cells from the outside, and the other burrows inside cells and attacks it from the inside. Doctors think this twin attack provides a ‘total block’ – stopping cancer cells dividing and rapidly killing them off. Early trials showed that the vast majority of women responded to the treatment, and for one in ten women their tumours simply vanished within 11 days.
Women given the combination will still need surgery to check that the tumour has disappeared, and to remove any remaining cells. But doctors hope that they will not need to undergo further treatments. Herceptin, given via a drip, latches on to the surface of the cell, stopping the HER2 protein working. Tyverb is given as a pill, working inside the cancer cells and blocking the HER2 signals that make the cells grow. In combination, the drugs also appear to boost the body’s immune response.
Published 10 March 2016 | By Ben Spencer
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