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Spring 2008

Research Helps Target Early Breast Cancers

Major strides in the understanding of the molecular processes involved in breast cancer are revolutionizing the way the disease is viewed and treated, says Sara Hurvitz, M.D., UCLA breast oncologist.

“For many years, it was assumed that breast cancers could be distinguished only by whether they were hormonereceptor positive or hormone-receptor negative,” Dr. Hurvitz explains. “Now we know that there are at least five or six distinct subtypes, all with differing biologies that probably warrant very different therapies. Our understanding of the molecular biology is allowing us to more effectively examine if the treatments we have been using are working.”

Research helps target early breast cancersThis reexamination has led to a major shift in the treatment of early breast cancers at UCLA and other major centers: the elimination of treatment regimens that use an anthracycline drug. Research at centers including UCLA has shown that this drug is only effective at targeting the 8 percent of all breast cancers that are positive for both HER2/neu and Topoisomerase IIa. Research has also shown that, for these patients, the far-less-toxic drug Herceptin (trastuzumab) is just as effective, thus obviating the need for anthracyclines.

Herceptin, which originated from research at UCLA, was the first of what are now several so-called targeted therapies for breast cancer: drugs that take direct aim at fixing the cancer biology rather than indiscriminately killing cells, as chemotherapy does. In addition to Herceptin, which is designed for the 25 percent of breast cancer patients with HER2-positive disease, the treatment arsenal now includes Tykerb (lapatinib), a drug targeting both HER2 and another receptor, EGFR. A third targeted drug, Avastin (bevacizumab), which just received FDA approval for use in treating metastatic breast cancer, works in part by limiting the growth of new blood vessels that supply the tumor. Clinical trials at UCLA are evaluating the drug’s benefit in earlier-stage breast cancer.

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