Enhertu breast cancer drug results in ‘ashona-off’ survival rate

The patients had metastatic breast cancer which was progressing despite rounds of rigorous chemotherapy. But a treatment with a drug that targets cancer cells with such precision as a laser was incredibly successful, slowing tumor growth and extending life to an extent that is rarely seen with advanced cancer.

The new study, presented at the annual meeting of the American Society of Clinical Oncology and published Sunday in the New England Journal of Medicine, will change how the drug was practiced, cancer experts say.

“This is a new standard of care,” said Dr. Eric Weiner, a breast cancer specialist, director of the Yale Cancer Center and head of ASCO. Wiener was not involved in the research. He added that “it affects a large number of patients.”

The trial focused on a specific mutant protein, HER2, which is a common villain in breast and other cancers. Drugs that block HER2 have been incredibly effective in treating breast cancer that is almost entirely protein-rich, turning HER2-positive breast cancer into patients who have some bad prognosis where patients spend very well.

But HER2-positive cases account for only 15 percent to 20 percent of breast cancer patients, says Dr. Haley Moore, director of breast medical oncology at the Cleveland Clinic. Only a few patients with HER2 cells – a condition known as HER2-low – were not helped by these drugs. Their cancer cells had only a small proportion of HER2, while other mutations initially triggered cancer growth. And it has created a problem because cancer cells have avoided chemotherapy treatment.

Clinical trials, sponsored by pharmaceutical companies Daiichi Sankio and AstraZeneca and led by Dr Shanu Modi of the Memorial Sloan Kettering Cancer Center, involved 557 patients with metastatic breast cancer who were HER2-low. Two-thirds of the experimental drugs were sold under the name Trustuzumab Deroxtecan, Enhartu; The rest have undergone standard chemotherapy.

In all patients who took Trustuzumab Deroxtecan, the tumors stopped growing for about 10 months, compared to 5 months in the case of standard chemotherapy. Patients on the experimental drug lived 23.9 months, compared to 16.8 months of those who received standard chemotherapy.

“Improving the survival of patients within six months for chemotherapy trials in metastatic breast cancer is unknown,” said Dr. Moore, who enrolled some patients in the study. In general, he said, success in a clinical trial is not an advantage of an extra few weeks of life or survival but an improved quality of life.

The results were so impressive that researchers received a standing ovation while presenting their data at an oncology conference in Chicago on Sunday.

Trastuzumab deruxtecan was already approved for patients with HER2-positive breast cancer, but very few people expected it to work because other drugs for this type of cancer failed in patients with HER2-deficiency.

The drug consists of an antibody that detects the HER2 protein on the cell surface. Antibodies are attached to a chemotherapy drug. When trustuzumab deroxtecan finds a cell with HER2 on its surface, it enters the cell and kills the cell by separating it from chemotherapy drug antibodies.

But what is “unique and unique” about Trostuzumab Derostecan, Dr. Modi adds that chemotherapy drugs enter through cell membranes. From there, it can travel to nearby cancer cells and kill them.

Like all chemotherapy, Trastuzumab Deroxtecan also has side effects, including nausea, vomiting, blood disorders and, significantly, lung injury that kills three patients on trial.

But, Dr. Winer says, “If I were a patient with metastatic breast cancer, and if I were to take a drug with side effects of chemotherapy, I would prefer this drug.”

Physicians say they plan to try to treat their breast cancer patients who have metastatic HER2-Low cancer.

“We’re all going back now and seeing our patients,” said Dr. Susan Domchek, a breast cancer specialist at the University of Pennsylvania’s Abramson Cancer Center. He said that before approving the Food and Drug Administration’s Trustuzumab Derostecan for HER2-deficient patients, he would see if the new research data would be enough to persuade insurers to approve the drug, which has a wholesale price of about $ 14,000 per person. Week

Dr Wiener emphasized that trstuzumab deroxetine is not a drug for early-stage breast cancer; It must still be tested in groups of patients. However, this is a possible next step, such as testing the drug on other cancers and expanding its strategy beyond HER2.

“This strategy is a real breakthrough,” he said, adding that it would enable researchers to zoom in on molecular targets in tumor cells that were rarely present.

“It’s more than just this drug or even breast cancer,” says Dr. Winer. “The real advantage is that it enables us to take powerful therapies directly to the cancer cells.”

One patient in the current study, Mary Smereker, age 55, of Medina, Ohio, said she felt she was temporarily relieved of certain deaths.

She was diagnosed with breast cancer in 2010 and underwent surgery, chemotherapy and radiation. Her cancer is gone.

“I thought I was independent and clean,” she said.

But in 2019, cancer returns. It spread to her pelvis. She had chemotherapy, but this time, there was little improvement.

Two years ago, he entered the trial at the Cleveland Clinic site. Her cancer did not go away, but the tumor stopped growing.

“I’m glad I got two more years,” said Mrs. Smareker. “My daughter is getting married next month. I never thought I would get married. “

Leave a Reply

Your email address will not be published.