YOUR HEALTH: Better breast cancer treatment

DUARTE, California – Allison Landherr was diagnosed with stage three HER2 positive breast cancer when she was 39.

"All of a sudden, you have this cancer diagnosis, and you stop everything and just try to figure out how are you going to survive."

The HER2 or Human Epidermal Growth Factor Receptor 2 is a gene that can play a role in the development of breast cancer.

Normally, HER2 receptors help control how healthy breast cells grow, divide, and repair themselves.  However in 25 percent of breast cancers, the HER2 gene doesn't work correctly and makes too many copies.  These extra genes cause the breast cells to make too many HER2 receptors, letting breast cells grow and divide in an uncontrolled way.

She had surgery, chemo, radiation, and a year of Herceptin.  She knew cancer returns for up to a quarter of patients after Herceptin.

Then, her doctor told her about Nerlynx, a targeted therapy that works inside cancer cells and blocks growth signals from different pathways.

"It irreversibly inactivates that and then downstream it can't signal, so that leads to in vivo, increased cell death," explained Dr. Linda Bosserman, medical oncologist with City of Hope National Medical Center near Los Angeles.

Allison took six pills a day for a year. she also took medicine for diarrhea, the worst side effect.

"Truthfully, life went on as normal throughout the treatment."

There already are available treatments specifically made for HER2-positive breast cancer.

  • Tykerb (chemically named lapatinib), which works against the cancer by blocking certain proteins that cause the uncontrolled cell growth
  • Perjeta (chemically named pertuzumab) blocks the cancer cells` ability to receive the growth signals
  • Herceptin (chemically known as trastuzumab) works against the HER2-positive breast cancers by blocking the ability of the cancer cells to receive chemical signals that tell the cells to grow
  • Kadcyla (chemically named T-DM1 or ado-trastuzumab emtansine) combines herceptin with chemotherapy medicine; it was designed to deliver emtansine to the cancer cells in a targeted way. It does this by attaching the emtansine to the herceptin, which then carries it to the cancer cells.

Dr. Bosserman says Nerlynx may not make a big difference for women in stage one but it significantly reduced recurrence for some women with more advanced cancer.

"For women with multiple nodes positive, estrogen positive, their risk can be up in that 30 percent range, and to lower that 34 percent is a profound benefit to women," she said.

Allison stopped taking Nerlynx eight months ago, is cancer-free and looking ahead.

"I want to see my children thrive and become independent and see what the future holds for them."

NEW TECHNOLOGY:  Nerlynx is a targeted therapy that works inside the cancer cells and blocks growth signals from multiple pathways.  The clinical trials for Nerlynx found that when patients took Nerlynx after treatment for HER2-positive breast cancer, it reduced the risk of recurrence.  The FDA has approved the drug so women can now have it prescribed by their doctors without the additional regulatory processes and paperwork.

Dr. Bosserman says Nerlynx reduces the risk of recurrence by 34 percent.   For individual patients, the actual improvement will depend on their risk of recurring.

  • Women with small, node negative tumors have 95 to 98% cure rates with standard therapy
  • Reducing the 2-5 percent recurrence risk by 34% means actually helping one to three women per 100 who get a year of therapy
  • Women with higher risk node positive, hormone positive stage 2 and 3 disease where risk of recurrence can be 30% means a 34% reduction would help about ten women per 100 treated.

BACKGROUND:  The HER2 or human epidermal growth factor receptor 2 is a gene that can play a role in the development of breast cancer. Also referred to as the ERBB2, it makes HER2 proteins. Normally, HER2 receptors help control how healthy breast cells grow, divide, and repair themselves. However in 25 percent of breast cancers, the HER2 gene doesn`t work correctly and makes too many copies; this is referred to as HER2 gene amplification. These extra genes cause the breast cells to make too many HER2 receptors, causing HER2 protein overexpression. This makes breast cells grow and divide in an uncontrolled way, making HER2-positive breast cancers spread and grow faster with a higher rate of coming back after treatment as compared to HER2-negative breast cancers.   (Source: http://www.breastcancer.org/symptoms/diagnosis/her2)

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.