Three-drug combination improves disease-free progression in metastatic HER2+ breast cancer
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Breast cancer responded to three-drug combination |
Adding capecitabine (Xeloda) as a third chemotherapy agent to the most commonly used first-line treatment for HER2-positive metastatic breast cancer significantly increases time to progression, according to an international study giving the first evidence of extra benefit with triple chemotherapy in this particularly aggressive form of the disease.
The study randomised 222 patients with metastatic breast cancer to the
standard first-line regimen — trastuzumab (Herceptin) plus docetaxel
(Taxotere) — with or without capecitabine, which is an oral form
of the chemotherapy agent 5-fluorouracil.
Results, reported this week at the European
Society for Medical Oncology congress in Istanbul, Turkey, showed that the median time to progression
increased from 13.8 to 18.2 months in patients who were also treated
with capecitabine (P=0.045).
Lead investigator Andrew Wardley, consultant medical oncologist at Christie
Hospital, Manchester, said that the improvement in time to progression
of 4.5 months with capecitabine was important in this group of patients. “Patients
with advanced stage HER2-positive breast cancer often have a poor prognosis
as their type of cancer does not always respond well to standard chemotherapy
regimens,” he warned. “Patients, who used to die within months,
can now live on for a year and a half on treatment, with good quality
of life,” he added.
Patients in the study treated with the three-drug combination showed
a positive trend in progression-free survival from a median of 12.8 to
14.8 months (P=0.060). The primary endpoint of overall response rate
(tumour shrinkage) was similarly high in both groups, at approximately
70 per cent. Patients in the study are still being followed up, with
final results expected in 2007.
Commenting on the study, Steve Williamson, lead pharmacist for Northern
Cancer Network and Northumbria Trust, said that it shows, once again,
that more aggressive treatments for breast cancer lead to improved results.
“This research extends the benefits of the National Institute for
Health and Clinical Excellence approved docetaxel/capecitabine combination
to
HER2-positive women,” he said. “Pharmacists must ensure they
have the capacity in place to adopt more complex regimens and work with
the nursing and medical teams to ensure concordance for patients taking
the extra oral capecitabine chemotherapy, and monitor the side effects
of the regimens,” he added. |
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Pharmaceutical Journal
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