Posted: December 12, 2020

Women with metastatic breast cancer (MBC) that overexpresses the Her-2 cancer gene — about 25% of all such women — have traditionally been treated with chemotherapy because of the aggressive nature of the disease.  About 50% of these women will also have hormone-receptor-positive tumors, making them amenable to hormonal manipulation.  Unanswered until now was the question of whether adding an intense form of Her-2 therapy — with two anti-Her-2 drugs — to hormonal therapy in those women not needing immediate chemo would be useful and produce meaningful improvement.  In a recent issue of the Journal of Clinical Oncology,  a large group of investigators from London asked this question.  They studied 355 women with MBC and divided them into three groups.  One group got a single Trastuzumab, the next got Lapatinib (both anti-Her-2 drugs) and the third group got both.  All three groups got an aromatase inhibitor as hormonal therapy.   None of these patients had immediately life-threatening disease, so chemo could be deferred.  The results showed clearly that double Her-2 therapy was better.  Women who received both anti-Her-2 drugs had remissions that lasted twice as long — roughly a year versus six months.   Side effects were modest and not worse in the group getting the two anti-Her-2 drugs.  You can access the abstract of the paper here, or ask Dr. Stark to send you the full manuscript by clicking on the box to the right.

Dr. Stark weighs in: “This study is arguably a baby step in the progressive improvement in the treatment of what is still a uniformly fatal disease — metastatic breast cancer.  Nonetheless it did add some value for the women so treated.  Stay tuned for newer developments.”