Back to:  List of Articles

The overexpression of HER-2/neu on tumor cells is associated with a bad prognosis in patients with breast cancer. Therefore, it seems logical from a therapeutic point of view to target this antigen with a monoclonal antibody (herceptin) which is commercially available in the US already.

With regard to the 25%-30% of patients presenting with an HER-2/neu overexpression Herceptin provides hope for a considerable proportion of patients with breast cancer. According to a randomised trial presented at the ASCO-Meeting the therapeutic approach of targeting HER-2/neu with Herceptin translates into impressive clinical efficacy. Compared to chemotherapy alone the combination with herceptin resulted in an increase of response rate and an advantage concerning survival (after a follow-up of >2 years). The median survival time could be increased from 20.3 months to 25.4 months by using herceptin in combination with chemotherapy.

Despite these encouraging data some questions remain to be investigated in future trials, said the experts at the meeting. Up to now it is unclear what the optimal treatment schedule of herceptin should be (long term treatment versus short term treatment) and which chemotherapy will lead to the best risk/benefit ratio. Some concerns arise when using herceptin in combination with doxorubicin because an increased risk of congestive heart failure has been reported. A more favourable result with regard to side effects can be expected when Herceptin is used in combination with taxanes as has been demonstrated by a study group at the Memorial Sloan-Kettering cancer institute in New York. Febrile neutropenias were rare, as was congestive heart failure. A response was seen in 62% of HER-2/neu-positive patients compared to 53% with paclitaxel alone.