Herceptin reduces the risk of death significantly if given to appropriate breast cancer patients after surgery and chemotherapy, a trial has indicated.

While it is not suitable for all patients, up to a quarter of women with breast cancer have the type of disease that it is designed to treat. Earlier trials have shown that it works, as well as raising some doubts about its side-effects.

The new trial, the Herceptin Adjuvant (Hera) study was designed to compare the outcomes for women treated with Herceptin for either one or two years after surgery and chemotherapy with those who had the same initial treatments but were then simply observed.

A report in The Lancet details the findings for 1,703 women who were given the drug for one year and were compared with another 1,698 who did not receive it.

After follow-up lasting another two years, the team responsible reports, 59 women in the Herceptin group had died compared with 90 in the control group — a 34 per cent reduction.

In absolute terms, 92.4 per cent of the women treated with Herceptin were still alive, compared with 89.7 per cent of those left untreated. There were more side-effects in the Herceptin group, of which the commonest was high blood pressure.

A total of twelve patients suffered from this, compared with only five in the control group.

Herceptin takers also suffered from a few cases of heart failure, depression, hot flushes and other side-effects.

Herceptin is a targeted drug that is effective in women whose cancers express the protein HER-2. It offers no advantages to other women with different breast cancer types.

Ian Smith, of the Royal Marsden Hospital, southwest London, who led the trial, said: “Our results indicate that Herceptin shows a significant overall survival benefit in early breast cancer over observation alone after chemotherapy.

“The survival benefit that has emerged over such a short period emphasises the potential of this approach and underlines the importance of developing further specific targeted therapies in breast and other cancers.”

Herceptin is an expensive drug, costing about £20,000 a year per patient. But its benefits have led to its approval by the Government’s cost-effectiveness watchdog, the National Institute for Health and Clinical Excellence (NICE).

Maria Leadbeater, a breast cancer specialist nurse at Breast Cancer Care, welcomed the results of the study.

She said: “This large-scale study confirms the potential benefits of Herceptin in people with HER-2-positive, early-stage breast cancer. We know, from the inquiries we receive about Herceptin from people with the disease, that many will be reassured that it confirms the drug’s effectiveness and importance as a treatment option.

“The study also reinforces current clinical recommendations on the length of treatment with the drug.

“Clearly there remains the need for further research into the long-term effects of Herceptin, which will enable us to establish the ideal duration of treatment along with a more thorough understanding of its side-effects.

“We look forward to future results that are anticipated from the Hera trial examining the effects of taking Herceptin for two years.”

A commentary in The Lancet by three researchers at the University of Sheffield who carried out the NICE analysis concludes that the benefits are real and that the cardiac damage caused by Herceptin is manageable.

“Over two years, the risk of cardiac damage seems trivial compared with that of breast cancer recurrence,” they say.

“Unless catastrophic long-term side-effects emerge for Herceptin, Hera is good news for women with HER-2-positive early breast cancer and adequate cardiac function.”

5000 - women in Britain who have breast cancer diagnosed each year could benefit from taking Herpectin

Source: Times database