North Central Cancer Treatment Group

Paclitaxel, Carboplatin and Trastuzumab Better Tolerated by HER2 Metastatic Breast Cancer Patients When Administered Weekly

CHICAGO — Women with metastatic breast cancer, who overexpress human epidermal growth factor receptor 2 (HER2), tolerate weekly administration of a combination of paclitaxel, carboplatin and trastuzumab better than women receiving the chemotherapy drug combination every three weeks, according to Edith Perez, M.D., principal investigator for the study, NCCTG 983252.

This North Central Cancer Treatment Group (NCCTG) study will be presented today at the 39th annual meeting of the American Society of Clinical Oncology (ASCO).

“This study will serve as the platform for other clinical trials to further improve the ultimate outcome for patients,” says Dr. Perez, director of the Cancer Clinical Study Unit and Breast Cancer Program at Mayo Clinic in Jacksonville and Chair of the NCCTG Breast Committee. She says a previous study reported by Nicholas Robert, M.D., in 2002 demonstrated the benefit of adding carboplatin to paclitaxel/trastuzumab for treating patients with HER2 positive breast cancer.

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“Our study looked at two different schedules of combining these three drugs — paclitaxel, carboplatin and trastuzumab,” Dr. Perez says. “We found that toxicity can be significantly reduced without losing effectiveness of the treatment if the drugs are given on a weekly basis instead of once every three weeks. In other words, patients can achieve good benefit from the tumor standpoint with few side effects.

“In my opinion, this is a step forward for improved patient treatment,” Dr. Perez says. “One of the most important avenues of research that can benefit patients today is to find out how to best use the agents we already have available.”

Dr. Perez says looking at new ways to combine existing drugs is especially important in treating metastatic disease. That’s because drugs commonly used to treat metastatic breast cancer are also used early in treatment to prevent development of metastatic disease and increase the likelihood of a cure.

The three-drug combination studied does not include an anthracycline, a class of drugs known to cause heart damage. This makes the drugs a safer alternative for treatment of breast cancer.

That fact, plus data from this study and others should influence standard of care, Dr. Perez says. “Although this is a modest-sized study, the data are compelling and should be considered for what could be another standard of care for patients with HER2-positive breast cancer,” she says.

This randomized, phase II study was supported by the National Cancer Institute and the Breast Cancer Research Foundation.

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The North Central Cancer Treatment Group is an affiliation of approximately 31 community clinics and affiliates in 18 states and two Canadian provinces. Its research base is at Mayo Clinic Cancer Center in Rochester, Minn. Established in 1977, NCCTG's major scientific programs focus on gastrointestinal, breast, lung and brain cancers. NCCTG also has an extensive cancer control program, which fosters research in cancer screening, prevention and symptom control. Visit http://ncctg.mayo.edu/ for more information.

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