A Finnish study on therapies for early breast cancer reports lower cardiac side effects among women who received a shorter than standard course of treatment with trastuzumab (Herceptin), according to a study published in the February 23 New England Journal of Medicine (NEJM).

To date, trastuzumab has been associated with heart failure among 1.7 to 4.1 percent of women taking the drug, and 10 percent of patients taking the drug have experienced substantial decreases in heart function.

The Finland Herceptin study administered trastuzumab to 116 women with HER2-positive tumors "before other cardiotoxic therapies and concomitantly with potentially synergistic chemotherapy for only 9 weeks to test the hypothesis that such a schedule would limit cardiotoxicity and maintain efficacy." This is different from previously published adjuvant studies in which anthracycline was given prior to trastuzumab. The patients were compared against a control group of 116 HER2-positive patients who received chemotherapy alone for 9 weeks without the addition of trastuzumab.  Read more  



Guest Update by Dr. John E. Niederhuber

Angiogenesis Initiative Fueling Collaboration

One of the most exciting new frontiers in cancer research is the increased focus on the tumor microenvironment. A major focus of this work is on the role of angiogenesis, the formation of new blood vessels to provide nutrients and oxygen to sustain the earliest development of a primary cancer or a metastasis. It was approximately 25 years ago that Dr. Judah Folkman first theorized in the pages of the NEJM that tumors needed to grow new blood vessels to fuel their development. Just 2 years ago, bevacizumab (Avastin) became the first agent specifically developed as an angiogenesis inhibitor to be approved by the Food and Drug Administration (FDA) for use in cancer patients to treat metastatic colorectal cancer.

Other FDA-approved anticancer agents - including bortezomib (Velcade) for the treatment of multiple myeloma and sunitinib (Sutent), which was approved just last month for the treatment of gastrointestinal stromal tumors - also have demonstrated the ability to inhibit angiogenesis. In addition, a number of new angiogenesis inhibitors are in development, including several in late-stage clinical trials, and researchers are finding that some already approved chemotherapy drugs, when used more frequently at doses far lower than standard cytotoxic regimens, target the tumor vasculature.  Read more  

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