THE vast majority of breast cancer sufferers who are not suited to the groundbreaking drug Herceptin may soon be able significantly to improve their chances of survival with a treatment that starves tumours of blood.

A trial involving patients with advanced breast cancer given Avastin, a drug designed to block the transfer of nutrients that feed a tumour, has shown that the treatment significantly slows the progression of the disease.

The findings prove the drug’s potential to keep later-stage cancers in check, effectively turning a death sentence into a chronic condition. Scientists told The Times last night that the study also suggested that Avastin might be able to eradicate cancers identified before they spread beyond the breast.

The research, to be presented tomorrow at the annual European Breast Cancer Conference in Nice, France, signals an important advance for the 80 per cent of breast cancer patients who cannot be treated with Herceptin because they have a tumour with the wrong genetic make-up.

Herceptin has been hailed as a cure for cancer after studies showed that it almost halves the risk of the disease coming back. However, the drug works by targeting a protein produced by cancers carrying the HER2 gene, which has been found to accelerate tumour growth.

Only about one in five patients has a cancer with this gene, and is thus eligible for Herceptin treatment.

The latest study suggests that the remaining 80 per cent of sufferers could have their tumour growth blocked using Avastin. Known generically as bevacizumab and manufactured by the pharmaceutical giant Roche, Avastin blocks the growth of new blood vessels that are needed for the cancer to grow and spread — or metastasise — beyond the breast.

The study, carried out by the US-based Eastern Co-operative Oncology Group, shows that people suffering from advanced breast cancer survive almost twice as long if they take Avastin in combination with standard chemotherapy. The two drugs fight the cancer on different fronts. The chemotherapy treatment, paclitaxel, attacks the tumour while Avastin interferes with the formation of blood vessels that starve it of nutrients. Denied sustenance, the tumours shrink.

Avastin is a monoclonal antibody, a substance that seeks out and binds to one of the more than 20 chemicals known to help blood vessels of tumours to grow. The one Avastin targets is called vascular endothelial growth factor, or VEGF. When Avastin binds to it, VEGF can no longer stimulate blood vessel growth.

Of the 772 patients in the trial, those only on paclitaxel had the progression of their tumour stopped for six months, while patients on both drugs avoided disease progression for almost a year.

Robin Zon, of Michiana Hematology-Oncology, a collaboration of oncologists in Indiana and Michigan, said that the study proved Avastin’s efficacy in controlling cancer. She said that patients on the drug combination had not shown any side-effects. Dr Zon told The Times that the results, which were in people with very serious cancer progression, suggested that the drug could dramatically improve outcomes for people with less advanced cancers.

“These results are good news for people with breast cancer. We have shown that this can work in some patients (with advanced breast cancer). By proving this activity, the hope is that we can take bevacizumab (Avastin) to the population with cancer in the breast and lymph nodes and improve the chance of curing them.”

Avastin was licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) for treatment of colorectal cancer after studies found that, when used in a similar combination, it dramatically improved survival. A spokesman for Roche said that while the drug was not currently available for breast cancer treatment, the company was starting recruitment this week of 700 patients with advanced cancer for another big trial.

It is expected that Avastin will be licensed for early-stage cancer by May next year, after an application by Roche to the MHRA. The National Institute for Health and Clinical Excellence, which advises on best practice for the NHS, will likely issue guidance soon afterwards.

If Avastin is advised for use across the health service, it will prove a huge financial headache for many trusts. The current cost of colorectal Avastin treatment adds up to £1,250 a dose, or £2,500 a patient per month.

Maria Leadbetter, a breast cancer specialist at Breast Cancer Care, welcomed the new findings as an important advance that offered much promise.

COMMON KILLER

Breast cancer is treated with surgery and radiotherapy, chemotherapy and hormone treatment, or a combination of treatments

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