Herceptin (trastuzumab) is a targeted therapy used for treatment of HER2 positive breast cancer. Results of a Phase II clinical trial showed that Herceptin might have a roll in treating patients with HER2 positive advanced bladder cancer.

The researchers conducted the clinical trial to examine the effectiveness of Herceptin along with chemotherapy in a little under fifty patients with advanced bladder cancer. The chemotherapy given with the Herceptin was paclitaxel, carboplatin, and gemcitabine.

This was a small study and research will have to continue to see if this treatment is something that will be put into mainstream use. The study concluded that:

• 11 percent of patients experienced a complete disappearance of detectable cancer.
• 59 percent of patients experienced a partial disappearance of detectable cancer.

Women treated with Herceptin (trastuzumab) in combination with chemotherapy for early stage breast cancer showed that after five years the risk of congestive heart failure did not increase with time.

The findings of the National Surgical Adjuvant Breast and Bowel Project (NSABP) were presented at the 43rd annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago last week.

Heart damage occurs in around 5 percent of patients treated with Herceptin. It is the most significant side effect; women with existing heart conditions cannot take the drug. The study showed that women were either susceptible to heart problems or they weren't. The risk of long-term problems is the same as the risk that is there from the beginning.

On Tuesday, researchers announced that a three-drug cocktail may help women with HER2-positive breast cancer better than any other drug used on its own. About one quarter of women with breast cancer make up this HER2 category.

Tests on mice revealed using the three drugs along with breast cancer drug tamoxifen helped wipe out tumors altogether. And the tumors did not come back. This is the first time mice were cured of a very aggressive human breast tumor. Incidentally, when a single drug was used, tumors returned within several weeks.

The three wonder drugs used in this study -- all are monoclonal antibodies that precisely target certain aspects of tumors -- are the experimental drug pertuzumab; trastuzumab, also known as Herceptin; and gefitinib, or Iressa.

Published in the Journal of the National Cancer Institute, this study supports the notion that HER2-positive tumors eventually become resistant to one drug and attacking them on several fronts seems to work better.

In September of 1998, the FDA approved Herceptin to treat breast cancer after it had become metastatic. Yesterday the FDA approved Herceptin's use for women diagnosed with breast cancer just after surgery. The drug is already widely prescribed for adjuvant therapy even without the FDA's approval, a practice called off-label use. Off-label use means that a prescription drug is being prescribed for a purpose not listed on the product's label. This is a common and acceptable practice by doctors and the Food and Drug Administration.

Clinical trials were conducted that showed women who received Herceptin (trastuzumab) given along with chemotherapy had fewer relapses than those who only received chemotherapy. Twenty to thirty percent of women diagnosed with breast cancer have this genetic alteration of the HER2 gene and could benefit by being treated with Herceptin.

Researchers at M.D. Anderson report on long-term cardiac status of patients receiving Herceptin. Trastuzumab (Herceptin), an anti-HER2 monoclonal antibody, is highly effective for treating HER2 overexpressing invasive breast cancer. In patients with HER2 positive metastatic breast cancer, Herceptin plus chemotherapy improved disease progression and overall survival compared with chemotherapy alone.

The study included patients who received Herceptin for at least one year. Most patients with Herceptin associated cardiac toxicity recovered completely, and many were re-treated with Herceptin without additional cardiac toxicity. Some patients did not discontinue use of Herceptin despite cardiac dysfunction.

This report suggests that patients who experience Herceptin induced cardiac toxicity should be managed with cardiologists and decisions to continue or resume Herceptin must be made after careful discussion of potential benefits and risks associated with further therapy.