Herceptin May Be of Little Use in Immune Cell-Heavy Breast Ca

The gist: Many women with HER2-positive breast cancer take the drug trastuzumab (aka Herceptin) along with chemotherapy after tumor-removal surgery to keep the cancer from returning. However, new research shows that women who have high levels of certain immune system cells in their tumors might not benefit from Herceptin. For these patients, chemotherapy might be just as effective at preventing the return of cancer as the chemo/Herceptin combo.

“HER2-positive breast cancers with a high level of immune cell infiltration might not benefit from the addition of trastuzumab (Herceptin) to chemotherapy, a trial analysis suggested.

“The 10% of patients with stromal tumor-infiltrating lymphocyte-predominant breast cancer in the Alliance N9831 trial showed similar recurrence-free survival (RFS) whether they received chemotherapy alone or with trastuzumab (10-year rate 90.9% versus 80.0%,P=0.21), Edith A. Perez, MD, of the Mayo Clinic in Jacksonville, Fla., and colleagues found.

“The rest showed, as expected, significantly better recurrence-free survival with addition of trastuzumab (10-year rate 79.6% versus 64.3%, hazard ratio 0.49, P=0.0003), they reported here at the San Antonio Breast Cancer Symposium.”


New Therapies Targeting Cancer could Change Everything

“In the summer of 2012, a year after his wife had died of lung cancer, Michael Harris scraped open an old mole on his back and it would not stop bleeding. The doctors said he had stage 4 melanoma, with a virtually inoperable tumor, and that patients in his condition typically lived about eight months. By last June, the cancer had spread to his liver and lungs.

“At that point Harris joined a clinical trial at Georgetown University, one of scores that have sprung up around the country to test a new class of cancer drugs called immune-checkpoint inhibitors. Two weeks after his first infusion, Harris’s primary tumor was fading, along with the black cancerous beads around it. A month later, his liver and lungs were clean.”


Immune System Cells Could be Trained to Attack Tumors

A type of white blood cell can infiltrate and attack tumors, and researchers have just launched a clinical trial of an experimental immunotherapy designed to sharpen this attack against melanoma. These white blood cells are called killer T cells, and the first step is collecting them from people with melanomas that have spread. Then two genes are inserted into the killer T cells to make them seek tumor cells. Next, the people are treated with chemotherapy to wipe out their remaining T cells, which do not recognize tumor cells as abnormal. The final step is treating people with their own genetically-modified killer T cells in hopes that these will then attack tumors. This phase I trial is currently recruiting participants.