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O N C OL OGY
B efore the targeted breast-cancer
drug Herceptin (trastuzumab) was
developed, women with high levels of
HER2+ protein — human epidermal growth
factor receptor 2-positive — had aggressive
tumors that were less likely to respond to
standard therapies. Now, these women,
approximately 25-to-30 percent of those
diagnosed with breast cancer, have among
the highest survival rates.
“The HER2+ story demonstrates that we
can provide more effective and less toxic
treatments by targeting therapies that are
most appropriate for the genetic changes
present in each patient’s tumor,” says
Dennis Slamon, MD, director of the Jonsson
Comprehensive Cancer Center’s Revlon/
UCLA Women’s Cancer Research Program
and the Translational Oncology Research
Laboratory at UCLA.
Led by Dr. Slamon, UCLA scientists
pioneered the research leading to the
development of Herceptin. The drug is now
standard treatment for women with HER2+
tumors. When used in combination with
other therapies, including chemotherapy or
surgery, it can dramatically reduce breast-
cancer recurrence rates.
“The earlier you use Herceptin in the disease
course, the better,” Dr. Slamon says, adding
Herceptin also is one of the few drugs that can
improve survival in late-stage breast cancer.
And despite recent theories about the optimal
period of time to use Herceptin, there is no
evidence that prolonging treatment beyond
one year will improve outcomes, he says.
“We believe there is a finite amount of time
that you need to be treated with the drug to
derive benefit if used correctly,” Dr. Slamon
says. “By using the drug beyond that time,
patients do not gain additional benefit, and
by discontinuing use, they do not lose benefit.”
In addition to fine-tuning the amount of time
to use Herceptin, researchers are also working
on ways to make the drug more powerful
and developing new treatments for women
with other types of tumors.
“The real excitement is around a new drug
called T-DM1,” Dr. Slamon says. T-DM1 is
Herceptin coupled with an experimental
chemotherapy drug, emtansine, or DM-1.
“It is like a smart bomb — Herceptin armed
with a warhead,” he says.
Initial studies in women with late-stage
HER2 breast cancer found that T-DM1 had
few side effects and increased progression-
free survival (the time between the start
of treatment and the time the cancer gets
worse) by three months, on average.
Most recently, UCLA researchers are
targeting a different and larger subset of
patients — women with advanced breast
cancers who are estrogen-receptor positive
(ER+) and HER2-negative, which accounts
for 60-to-65 percent of breast cancers in
most countries. Preliminary results show
that women taking the investigational
drug palbociclib, in addition to letrozole,
a commonly used drug for ER+ breast cancer,
had significantly higher progression-free
survival than patients taking standard
treatment alone. “The benefit is the largest
we’ve seen to date in this large subgroup,
tripling disease-control times from seven-
and-a-half months with the available
standard therapies to more than two years
and counting with the experimental therapy,”
Dr. Slamon says.
“By identifying the correct targets for
treatment in the right patient population, we
move forward with personalized oncology
that we hope will greatly improve the
outcomes for this group of patients with
breast cancer,” Dr. Slamon says.
For information about breast-cancer
clinical trials at UCLA, go to:
cancer.ucla.edu UCLA Breast Centers Offer Broad Range of Services in One Place
UCLA’s specialized breast centers in Westwood and Santa Monica offer women with breast cancer one-stop locations where they
can receive integrated care that includes the latest in imaging technology and care coordination to assist them through the process.
The multidisciplinary clinics enable a patient to see all the specialists necessary for her diagnosis and treatment, and leave with
a comprehensive care plan. The latest imaging technology available at the two centers includes tomosynthesis, which provides a
three-dimensional image that improves breast-cancer diagnosis by increasing detection of invasive breast cancers and by reducing
Care coordination also is available to help schedule appointments, answer questions and guide patients through interactions with
the health system during diagnosis, treatment and follow-up.
Revlon/UCLA Breast Center
UCLA Breast Center Santa Monica
200 UCLA Medical Plaza, Suite B265 (B2 Level)
Los Angeles, California 90095
1223 16th Street, Suite 1100
Santa Monica, CA 90404
Vital Signs Winter 2014 Vol. 61