Nigel Hawkes, Health Editor
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A new breast cancer drug has shown impressive results in shrinking tumours before surgery.
Lapatinib (Tyverb) is licensed in the United States for advanced breast cancer but not in the European Union. It is similar to Herceptin in the way that it works – it inhibits the action of an emzyme that prompts the tumour to grow.
At the European Breast Cancer Conference in Berlin, Angel Rodriguez, of Baylor College of Medicine in Houston, Texas, reported on a trial in which lapatinib was given to 45 women for six weeks before they underwent surgery. The tumours shrank by an average of more than 60 per cent, and the drug also cut the number of breast cancer stem cells.
This was important, Dr Rodriguez said, because such cells had proved resistant to other drugs used before surgery. Indeed, the effect of conventional drugs was to increase the number of stem cells and enhance tumour growth. “We were excited to see that the results with lapatinib were different,” he said.
Cancer stem cells help to maintain the malignant tissue in the tumour by regenerating it after attack from chemotherapy drugs.
“This indicates that the stem cells themselves should be the specific target of chemotherapy drugs,” said Dr Rodriguez. “Rather than the broad-brush approach, in which cells are killed indiscriminately, targeting the stem cells may be more effective and also prevent some of the unpleasant side-effects associated with conventional chemotherapy treatment.
“This is an exciting finding and we will be starting further studies on stem cells in order to confirm it. This finding should also apply to other types of cancers, and research of tumour-initiating stem cells in other cancers is ongoing,” he said.
These include studies in lung, colon, head and neck, gastric, oesophageal, and bladder cancer and lymphoma, among others.
Carolyn Rogers, a clinical nurse specialist at Breast Cancer Care, said: “Lapatinib is being considered for use in secondary breast cancer following clinical trials, but to date there is no strong evidence to show its suitability in treating primary breast cancer.
“Dr Rodriguez’s study provides an interesting insight into how lapatinib could be used in early breast cancer. However, with a sample of just 45 patients it is clear that much more work needs to be done to gain statistically significant findings. Further trials are under way but it will be many years before we see the full results of these. Current approved treatment options are very successful, with survival rates increasing year on year.”

Microscopic magnets could be used to guide modified human cells to attack tumours, according to research (Mark Henderson writes).
The technique, which combines nanotechnology and gene therapy, could help specially “armed” human immune cells to home in on cancer cells to destroy them. A team led by Professor Claire Lewis, at Sheffield University, developed a procedure that involves inserting nanomagnets into a type of white blood cell. When a magnet is placed over a tumour, the cells move towards it and attack. Details are published in the journal Gene Therapy.
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if you are unable to take herceptin, what other options are in Canada for treating advanced her2 type breast cacer.
Kim Irwin, Dunsford, Ontario