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Canadian cardiology team clears the way for lifesaving breast cancer treatment
October 26, 2009Edmonton − A team of Canadian cardiologists, in collaboration with oncologists, are playing an important role in the war against breast cancer Dr. Michael McDonald told the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.
At issue is how to use a highly effective drug therapy for early-stage breast cancer while maintaining the cardiovascular health of the patient. The drug - trastuzumab (herceptin) - inhibits cancer cell survival. Herceptin is prescribed as an adjuvant to other standard chemotherapy treatments.
Unfortunately, some women will develop serious heart complications as a result of herceptin-based treatment.
"These are women with no previous heart problems," says Dr. McDonald, a cardiologist.
In a worst case scenario, thousands of women could be denied a potentially life-saving therapy.
Thanks to a study by Dr. McDonald and colleagues from the Heart Function Clinic at Toronto General Hospital, there is hope for these women. They found that the affected patients can be taken off the medication and treated for the heart condition, allowing them to resume the cancer treatment unaffected.
"Approximately 25 per cent of breast cancer patients will be candidates for herceptin treatment. Of that number, approximately four to 10 per cent will develop a serious heart condition which may result in congestive heart failure, forcing them to stop their treatment," he says.
These patients develop a decline in their heart function - or ejection fraction - which puts them at risk for congestive heart failure.
The team examined 18 consecutive breast cancer patients, treated with herceptin, whose ejection fractions had dropped by at least 10 per cent or who were showing signs of heart failure. Following diagnosis of the heart complications, herceptin treatment was suspended in 13 patients while heart failure treatment with ACE inhibitors and/or beta blockers was initiated.
"After three months of follow-up, the cardiac complications had begun to improve and almost all patients had a near normalization of ejection fraction," says Dr. McDonald.
"Our study shows herceptin-related toxicity is largely reversible," he says. "A systematic, guideline-based approach to management including referral to a cardiology centre, temporary cessation of herceptin if necessary, and judicious use of heart failure medications can lead to a successful outcome for these patients."
But the news gets even better.
"We tested 14 of the 18 patients who were put back on herceptin and they were all able to complete the course of treatment," Dr. McDonald told the meeting.
The million dollar question is: does herceptin cause lasting damage to the heart? With the development of newer cancer medications that act in a similar fashion to herceptin, understanding the effect of this therapy on the cardiovascular system and response to intervention is critically important.
"It requires cross-specialty teamwork but dealing with herceptin-related cardiac problems is a challenge that can be met," says Dr. McDonald.
Heart and Stroke Foundation spokesperson Dr. Beth Abramson agrees: "This is good news for Canadian women," she says. "Heart disease and cancer are the two leading causes of death for women in this country. Hopefully ongoing collaboration between physicians in these fields will reduce both of these serious health threats to Canadian women − and save lives."
Abramson says prevention of heart disease and breast cancer share similar strategies, including following a heart healthy low-fat diet, increased physical activity, smoking cessation, and maintaining a healthy body weight.
Heart and Stroke Foundation of Canada
"These are women with no previous heart problems," says Dr. McDonald, a cardiologist.
In a worst case scenario, thousands of women could be denied a potentially life-saving therapy.
Thanks to a study by Dr. McDonald and colleagues from the Heart Function Clinic at Toronto General Hospital, there is hope for these women. They found that the affected patients can be taken off the medication and treated for the heart condition, allowing them to resume the cancer treatment unaffected.
"Approximately 25 per cent of breast cancer patients will be candidates for herceptin treatment. Of that number, approximately four to 10 per cent will develop a serious heart condition which may result in congestive heart failure, forcing them to stop their treatment," he says.
These patients develop a decline in their heart function - or ejection fraction - which puts them at risk for congestive heart failure.
The team examined 18 consecutive breast cancer patients, treated with herceptin, whose ejection fractions had dropped by at least 10 per cent or who were showing signs of heart failure. Following diagnosis of the heart complications, herceptin treatment was suspended in 13 patients while heart failure treatment with ACE inhibitors and/or beta blockers was initiated.
"After three months of follow-up, the cardiac complications had begun to improve and almost all patients had a near normalization of ejection fraction," says Dr. McDonald.
"Our study shows herceptin-related toxicity is largely reversible," he says. "A systematic, guideline-based approach to management including referral to a cardiology centre, temporary cessation of herceptin if necessary, and judicious use of heart failure medications can lead to a successful outcome for these patients."
But the news gets even better.
"We tested 14 of the 18 patients who were put back on herceptin and they were all able to complete the course of treatment," Dr. McDonald told the meeting.
The million dollar question is: does herceptin cause lasting damage to the heart? With the development of newer cancer medications that act in a similar fashion to herceptin, understanding the effect of this therapy on the cardiovascular system and response to intervention is critically important.
"It requires cross-specialty teamwork but dealing with herceptin-related cardiac problems is a challenge that can be met," says Dr. McDonald.
Heart and Stroke Foundation spokesperson Dr. Beth Abramson agrees: "This is good news for Canadian women," she says. "Heart disease and cancer are the two leading causes of death for women in this country. Hopefully ongoing collaboration between physicians in these fields will reduce both of these serious health threats to Canadian women − and save lives."
Abramson says prevention of heart disease and breast cancer share similar strategies, including following a heart healthy low-fat diet, increased physical activity, smoking cessation, and maintaining a healthy body weight.
Heart and Stroke Foundation of Canada
Herceptin Current Events and Herceptin News RSSFDA approved leukemia drugs shows promise in ovarian cancer cells
The drug Sprycel, approved for use by the U.S. Food and Drug Administration in patients with chronic myeloid leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, a study by researchers with UCLA's Jonsson Comprehensive Cancer Center found.
Early-stage, HER2-positive breast cancer patients at increased risk of recurrence
Early-stage breast cancer patients with HER2 positive tumors one centimeter or smaller are at significant risk of recurrence of their disease, compared to those with early-stage disease who do not express the aggressive protein, according to a study led by researchers at The University of Texas M. D. Anderson Cancer Center.
Hunting for the Prozac Gene
Prozac works wonders for some depressed people, but not for others. In some cases, patients derive little benefit and at worst, it can lead to bizarre hallucinations and fits of rage.
Information about the use and accuracy of breast cancer tests is lacking, study finds
A new study finds that there is little information available about the use of new testing technologies and targeted therapies in breast cancer, specifically the anti-cancer drug trastuzumab (Herceptin).
Antibody targeting of glioblastoma shows promise in preclinical tests, say Lombardi researchers
Cancer researchers at Georgetown University's Lombardi Comprehensive Cancer Center have successfully tested a small, engineered antibody they say shuts down growth of human glioblastoma tumors in cell and animal studies. Glioblastoma is the deadliest of brain cancers; there is no effective treatment.
Triple drug combination is promising option to treat metastatic HER2+ breast cancer
Combining two chemotherapy drugs with trastuzumab (Herceptin) to treat women who have metastatic HER2+ breast cancer may offer physicians another choice in their treatment options.
Breakthrough model for human cancer may improve development of cancer drugs; study in PNAS
AVEO Pharmaceuticals, Inc., a biopharmaceutical company leveraging breakthrough discoveries in cancer biology to discover, develop and commercialize targeted oncology therapies, today announced findings from its novel human-in-mouse (HIM) cancer model system, in which AVEO successfully created invasive human tumors from primary human breast tissue that develop over time in mice and mimic human tumor behaviors and response.
Light reveals breast tumor oxygen status
Light directed at a breast tumor through a needle can provide pathologists with biological specifics of the tumor and help oncologists choose treatment options that would be most effective for that individual patient.
Lombardi research: Monoclonal antibodies primed to become potent immune weapons against cancer
New research suggests that monoclonal antibody therapy of cancer can be improved to be much more powerful than it is today, says a researcher at Georgetown University Medical Center's Lombardi Comprehensive Cancer Center in the March 21 issue of the Lancet.
Nanoscopic probes can track down and attack cancer cells
A researcher has developed probes that can help pinpoint the location of tumors and might one day be able to directly attack cancer cells.
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