"Trojan Horse" drug could be next advance in treatment of breast cancer

10:28 PM, May 1, 2009   |    comments
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By Kay Quinn, Healthbeat Reporter

KSDK -- There's a story from ancient times that tells of how the Greeks hid in the figure of a horse, entered the city of Troy secretly and won a ten year war. Now the story of the Trojan Horse is being used to describe an emerging treatment in the fight against breast cancer.

The analogy began after scientists took a common chemotherapy drug and added it to herceptin, a tried-and-true breast cancer drug usually given alone. But local doctors plan to test this drug duo in a bigger group of patients to see if it works better than herceptin alone.

"It is very exciting," says Dr. Timothy Pluard, a researcher at Washington University School of Medicine, and an oncologist at Barnes-Jewish St. Peters.

Dr. Pluard will run the local arm of the study, scheduled to start in patients in our area this month.

"Right now probably anyone who has advanced HER2 positive breast cancer that has spread," says Dr. Pluard.

Twenty to 30 percent of all breast cancer patients have HER2 positive breast cancer. It means they have a protein in their cells that turns genes on and off.

Because this process is stuck in the on position, their cancer cells grow unchecked.

Herceptin stops that process, which increases the survival of patients, even those whose cancer has spread. But it only works for a time.

"Most patients with advanced HER2 positive breast cancer respond to herceptin, but eventually develop resistance," says Dr. Pluard.

Usually within a year; that's where this Trojan Horse drug, called T-DM1, comes in. A common and effective chemotherapy drug, called DM1, is added to herceptin, the T. Because herceptin only enters cancer cells, it carries the chemotherapy only into the cells that are growing out of control.

"In essence it is a smart bomb, it knows where to go and deliver its chemotherapy," says Dr. Pluard.

In effect, reducing the amount of chemotherapy a patient is exposed to, while increasing the strength of the treatment.

"The treatment is given just like herceptin, intravenously once every three weeks," says Dr. Pluard.

Early studies show T-DM1 is well tolerated and works in about one-third of patients with advanced breast cancer.

"Most of the side effects actually are related to the herceptin," says Dr. Pluard. "The chemotherapy that's attached to the herceptin has very few side effects at all."

You can support important research like this, as well as breast cancer screening and education by getting involved in this year's Komen St. Louis Race For The Cure, set for Saturday, June 13, in downtown St. Louis.

For more information on the Komen Race for the Cure, click here.


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