英国癌症研究所的突破：药物联用在11天内根除了乳腺癌
Cancer breakthrough? Drug combo eradicated breast cancer tumors in 11 days
2016年3月11日星期五出版。
有一天，一个抗癌药物组合可以消除患有HER2阳性乳腺癌的女性的化疗需求; 在一项新的研究中，两种药物的结合被发现可以在确诊后的11天内彻底根除或显著缩小乳腺癌肿瘤。
HER2阳性乳腺癌患者在接受曲妥珠单抗和拉帕替尼治疗后，肿瘤完全根除或显著减少。
英国癌症研究所(ICR)的首席研究员Judith Bliss教授和他的同事最近在荷兰阿姆斯特丹举行的第十届欧洲乳腺癌会议(EBCC-10)上展示了他们的EPHOS B试验结果。
继皮肤癌之后，乳腺癌是美国女性中最常见的癌症。据估计，每8个美国女性中就有1个会在她们生命中的某个时刻被诊断为一种侵入性的疾病。
根据美国癌症协会的数据，大约五分之一的乳腺癌是人类雌激素受体2阳性，或HER2阳性。这意味着肿瘤细胞中HER2基因的拷贝过多，导致HER2蛋白的过量分泌。
与其他乳腺癌相比，HER2阳性乳腺癌的扩散速度更快，扩散幅度更大，这种癌症的患者在治疗后更容易复发。
目前对HER2阳性乳腺癌的治疗包括手术、化疗和激素治疗。还有一些药物可以靶向并阻断乳腺癌细胞上的HER2受体，比如曲妥珠单抗(Herceptin品牌)，它是治疗HER2阳性乳腺癌最常见的药物。
近年来，新的抗HER2药物进入市场，其中包括拉帕替尼(品牌名Tyverb或Tykerb)，但目前该药物仅用于治疗晚期HER2阳性乳腺癌。
接受药物治疗的女性中，有11%的人肿瘤消失。
在他们的研究中，布利斯教授和同事开始研究曲妥珠单抗和拉帕替尼如何在诊断和手术之间的短时间内影响her2阳性乳腺癌肿瘤。
关于乳腺癌的快速事实
今年，大约有246660名美国女性将被诊断为浸润性乳腺癌
2016年，大约40450名女性将死于乳腺癌
在美国有超过280万的乳腺癌幸存者。
了解更多关于乳腺癌的信息
该研究小组招募了257名被诊断为HER2阳性乳腺癌的女性，并将她们在诊断和手术之间的11天内分成三组;一组接受曲妥珠单抗，一组接受拉帕替尼，最后一组不接受治疗，代表对照组。
然而，先前的研究表明曲妥珠单抗和拉帕替尼联合治疗HER2阳性乳腺癌可能有效。因此，研究小组在试验进行到一半时对试验进行了修正，使拉帕替尼组的女性也接受了曲妥珠单抗。
在11天的治疗前后，研究人员测量了女性乳腺癌肿瘤细胞增殖的生物标记，包括ki67蛋白水平和细胞凋亡程序性死亡。
然而，他们发现，在66名同时接受曲妥珠单抗和拉帕替尼治疗的女性中，约有四分之一的人的肿瘤太小，无法测量细胞的增殖。
研究小组发现，17%的接受药物联合治疗的妇女体内残留的疾病很少，即肿瘤直径小于5毫米，而另外11%的妇女体内残留的药物已经根除了肿瘤，这是一种完全的病理反应。
相比之下，只有3%的仅接受曲妥珠单抗治疗的女性发现了微小的残留疾病或完全的病理反应，而对照组的女性没有发现任何反应。
研究小组指出，许多接受联合治疗的女性都患有第二期乳腺癌，癌细胞已经扩散到淋巴结。
这个发现有开创性的前景
根据他们的研究结果，研究人员建议，在手术前使用曲妥珠单抗和拉帕替尼联合治疗可能是治疗HER2阳性乳腺癌的有效治疗方案，可能会消除化疗的需要。
研究报告的合著者、英国曼彻斯特大学和英国南曼彻斯特大学国家卫生服务(NHS)信托医院的奈杰尔·邦德里德教授在评论研究结果时说:
“这具有突破性的潜力，因为它使我们能够识别出一组患者，他们在11天内仅通过抗HER2疗法就消失了肿瘤，而且可能不需要随后的化疗。”这为每个女性提供了量身定制治疗的机会。
布利斯教授在《每日电讯报》上撰文称，他们在11天内就能根除肿瘤的可能性是“惊人的”。
她补充说:“这表明，在未来，如果这些发现在更大的试验中得到重复，同时也评估了这些反应对长期疾病结果的影响，一些女性可能可以避免化疗，以及化疗可能带来的副作用。”
Cancer breakthrough? Drug combo eradicated breast cancer tumors in 11 days
Published Friday 11 March 2016 By Honor Whiteman
A cancer drug duo could one day eliminate the need for chemotherapy for women with HER2-positive breast cancer; in a new study, a combination of two drugs was found to completely eradicate or significantly shrink breast cancer tumors within 11 days of diagnosis.
[A woman checking her breast]
Women with HER2-positive breast cancer saw a complete eradication or significant reduction in tumors when treated with both trastuzumab and lapatinib.
Lead researcher Prof. Judith Bliss, of the Institute of Cancer Research (ICR) in the UK, and colleagues recently presented the results of their EPHOS B Trial at 10th European Breast Cancer Conference (EBCC-10) in Amsterdam, the Netherlands.
After skin cancer, breast cancer is the most common cancer among women in the US. It is estimated that 1 in 8 American women will be diagnosed with an invasive form of the disease at some point in their lives.
According to the American Cancer Society, around 1 in 5 breast cancers are human epidermal growth factor receptor 2-positive, or HER2-positive. This means the cancer tumors have too many copies of the HER2 gene, resulting in excess production of the HER2 protein.
Compared with other breast cancers, HER2-positive breast cancers tend to spread faster and more aggressively, and patients with this type of cancer are more likely to experience recurrence following treatment.
Current treatments for HER2-positive breast cancer include surgery, chemotherapy and hormone therapy. There are also drugs available that target and block the HER2 receptors on breast cancer cells, such as trastuzumab (brand name Herceptin), which is the most common medication for HER2-positive breast cancer.
In recent years, new anti-HER2 drugs have entered the market, including lapatinib (brand name Tyverb or Tykerb), though this drug is currently only used to treat advanced HER2-positive breast cancer.
11% of women treated with drug combo saw tumors disappear
For their study, Prof. Bliss and colleagues set out to investigate how trastuzumab and lapatinib affected HER2-positive breast cancer tumors in the short window between diagnosis and surgery.
Fast facts about breast cancer
This year, around 246,660 women in the US will be diagnosed with invasive breast cancer
Around 40,450 women will die from breast cancer in 2016
There are more than 2.8 million breast cancer survivors in the US.
Learn more about breast cancer
The team enrolled 257 women who had been diagnosed with HER2-positive breast cancer and allocated them to one of three treatment groups for the 11 days between diagnosis and surgery; one group received trastuzumab, one group received lapatinib and the final group received no treatment, representing the control group.
However, previous research has suggested that a combination of trastuzumab and lapatinib may be effective against HER2-positive breast cancer. As such, the team amended the trial halfway through, so that women in the lapatinib group also received trastuzumab.
Before and after the 11-day treatment period, the researchers measured biological markers of cellular proliferation in the women's breast cancer tumors, including levels of the ki67 protein and apoptosis - programmed cell death.
However, they found that for around a quarter of the 66 women who received both trastuzumab and lapatinib, their tumors were too small to measure cellular proliferation.
The team found that 17% of women treated with the drug combination had minimal residual disease - defined as a tumor that is smaller than 5 mm in diameter - while for a further 11%, the drugs had eradicated their tumors, representing a complete pathological response.
In comparison, minimal residual disease or a complete pathological response was identified in just 3% of women treated with trastuzumab only, while neither response was identified among women in the control group.
The team notes that many of the women who responded to the combination therapy had stage 2 breast cancer, where the cancer has spread to the lymph nodes.
Findings have 'groundbreaking potential'
Based on their findings, the researchers suggest that therapy involving a combination of trastuzumab and lapatinib prior to surgery could be an effective treatment option for women with HER2-positive breast cancer, potentially eliminating the need for chemotherapy.
Commenting on the results, study coauthor Prof. Nigel Bundred, of the UK's University of Manchester and the University Hospital of South Manchester National Health Service (NHS) Trust, says:
"This has groundbreaking potential because it allows us to identify a group of patients who, within 11 days, have had their tumors disappear with anti-HER2 therapy alone and who potentially may not require subsequent chemotherapy. This offers the opportunity to tailor treatment for each individual woman."
Writing about their findings in The Telegraph, Prof. Bliss says the possibility that they can eradicate a tumor in just 11 days is "remarkable."
"It suggests that in future - if the findings are replicated in larger trials which also assess the effects of these responses on long-term disease outcomes - some women might be able to be spared chemotherapy, and the side effects it can bring," she adds.
Earlier this month, Medical News Today reported on another potentially groundbreaking cancer discovery, in which researchers claim they have found a way to encourage the immune system to target and destroy cancer cells, bringing us closer to a personalized cancer vaccine.
Cancer breakthrough? Drug combo eradicated breast cancer tumors in 11 days https://www.medicalnewstoday.com/articles/307800.php?sr
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