Breast cancer patients' drug hope

Drug therapy could be used to treat many cancers

A combination of two powerful new drugs has shown signs of helping to control tumour growth in breast cancer patients, research shows.

The agents could also have potential for use in the treatment of many other cancers, it is suggested by the Italian team which carried out the study.

They found that trastuzumab, known as Herceptin and the as yet unlicensed drug ZC1839, referred to as Iressa, act synergistically against two rogue genes commonly involved in breast cancer.

However, even Herceptin on its own is not readily available in many parts of the UK - despite being available in other countries for some years.

This approach is still highly experimental, but our findings could in theory be transferred immediately to patients in the clinic

Dr Nicola Normanno

"I would stress this approach is still highly experimental, but our findings could in theory be transferred immediately to patients in the clinic," said lead investigator Dr Nicola Normanno.

Herceptin and Iressa differ from conventional cell-killing cancer drugs in that they have been tailor-made to work against specific oncogenes which produce cancerous cells.

Herceptin is increasingly used, either alone or combined with chemotherapy, to combat advanced breast cancer.

Iressa is being used as a single agent in combination with other therapies in clinical trials in a range of cancers.

Target therapy

The drugs were tested singly on breast cancer cells expressing the two oncogenes - HER2 and EGFR, according to a report in the journal Annals of Oncology .

Herceptin and Iressa were each able to inhibit cancer cell growth by 30 to 55%.

However, when the two agents were used together, the rate rose to 70%.

Tests to check whether the two treatments were enhancing each other confirmed they were acting synergistically.

Treatment using this "target therapy" approach would not be restricted to breast cancer, but could be applied to a range of tumours.

Dr Normanno said: "Eventually these combinations may be used with conventional cell-killing drugs.

"Alternatively, conventional chemotherapy may be used for short courses at times when the disease is more aggressive and targeted therapy used at other times.

"The purpose would be to control tumour growth rather than destroying the number of tumour cells, shifting our overall aim from the often unachievable objective of eradicating all traces of cancer to the more realistic one of keeping the disease under control."

The Cancer Research Campaign (CRC) has welcomed the findings.

The CRC's Dr Mary Berrington said: "The ability to home in on specific, abnormal pathways in the cancer cell will provide a myriad of new possibilities for treatment.

"Many new targeted treatments are under development, and a crucial thing now will be to determine how best to use them - at what stage of disease and in what combination with each other and with conventional treatments."

Non-Hodgkin's lymphoma

Meanwhile, scientists in Switzerland have reported encouraging developments in treating non-Hodgkin's lymphoma (NHL) with a combination of drugs and chemotherapy.

The use of anti-cancer drug MabThera, also called rituximab, in conjunction with standard chemotherapy can increase the chance of a cure and prolong survival in NHL, an increasingly common form of blood cancer.

Those treated with MabThera plus chemotherapy, showed an overall survival rate of 70%, compared with 57% with chemotherapy alone, according to a report in the New England Journal of Medicine.

Drugs would be combined with chemotherapy

Lead study co-ordinator Professor Bertrand Coiffier said: "Previously standard chemotherapy had only a 30 to 40% cure rate in aggressive NHL, a disease that can be rapidly fatal.

"The complete remission rates seen with this new combination are very encouraging and indicate a real change in the way this disease can be treated from now on.

"For the first time in 20 years we have a new drug combination that shows an increased chance of cure and an improvement in overall survival."

NHL affects about 1.5 million people around the world and is the third fastest growing form of cancer behind melanoma of the skin and lung cancer.

It is also a more common form of blood cancer than leukaemia.