This patient-friendly article is about chemotherapy drug, Herceptin is no ’wonder’ drug. Herceptin, or Trastuzumab, was launched in a blaze of glory with extensive PR criticising and blaming any Health Authority or Hospital that dared to question it. "Poor Mrs Jones is being denied life saving treatment", was the usual Newspaper story, inspired as always by Big Pharma propaganda.
And Herceptin does work. It is a monoclonal antibody, the first of its kind, to treat women with breast cancer that had an over-expression of HER2 protein. Before Herceptin there was nothing. But, as we will see, the ’wonder’ claims were over the top. The drug may work for 5 years; but in some cases just two, and already there is a second drug Pertuzumab, developed to extend the life and effectiveness of Herceptin. There is also a third drug Tyverb - which does well or badly, depending on which research study you read.
The Truth about Breast cancer nowadays is that a staggering 40 per cent is being diagnosed in the under 60s age group, making the ’cancer is an old person’s disease claims’ of CRUK seem a bit ridiculous.
And nowadays, up to to 25% of breast cancer is not ER+ (estrogen driven). It is Triple Negative Breast cancer or only HER2 positive. Of course, women can also be ER+ and HER2+.
Further on in the article, we will give you a link to some natural compounds known to be effective against HER2+ breast cancer (and TNBC) and known to help Herceptin work.
Breast cancer background
When a women is diagnosed with breast cancer the origins may lie in the lobes (lobular) or in the ducts (ductal, or DCIS). She will also be tested and told whether she is positive or negative for oestrogen, progesterone, or HER2.
Oestrogen, or estrogen, is known to drive many breast cancers by causing changes inside healthy cells, by causing stem cells to stay in this rapidly dividing state, and by even causing damaging mutations.
Oestrogen is the collective name for a family of compounds, some dangerous, others far less so. For example, you can also absorb chemicals from some pesticides and in-home products that can act like oestrogen in your body.
Go to: 10 Ways To Cut Estrogen Levels Naturally
Tamoxifen is used to block the action of oestrogen on receptor sites of both healthy cells and cancer cells. It is normally given to women who are pre-menopausal.
Aromatase inhibitors (AIs) aim to block the production of oestrogen in your body in the first place. After menopause oestrogen is produced by aromatase enzymes from your fat stores. Inhibitors include Anastrozole (Arimidex); Exemestane (Aromasin) and Letrozole (Femara). Oestrogen is principally made in the ovaries pre-menopause, but up to 60 per cent of it can be made in other tissues. Thus AIs are most often used in women who have reached menopause.
Finally, much work is being done on women who are neither oestrogen positive (ER+) or Progesterone positive (P+). One breakthrough was finding a group of women (about 20 per cent in total) who were HER-2 positive. About half of these respond positively to a monoclonal antibody called Herceptin.
Newer work is focussing on PARP inhibitors for women who are not any of the above, and on drugs to kill cancers caused by stem cell developments, and more.
But for this article we will cover just Herceptin.
One thing to remember is that drugs can’t do it all. Japanese women have been shown to have a much lower incidence of recurrence of breast cancer than Western women. Diet and lifestyle were the reasons given by the researchers (Int Radiation Oncol 2005; 62). Other research we have covered has signalled the importance of good levels of omega 3 and vitamin B-12. In a 2008 Study from the University of Toronto, women with good blood levels of vitamin D survive far longer than those with deficiencies. And women who take daily exercise double their survival rates.
Herceptin (Trastuzumab)
Herceptin is the only monoclonal antibody treatment currently available for breast cancer. The drug was first approved in the USA in 1998 for women whose advanced, metastatic breast cancer was HER2 positive. In 2006 it was approved for use in early stage patients too.
Wikipedia states: The original studies of trastuzumab showed that it improved overall survival in late-stage (metastatic) breast cancer from 20.3 to 25.1 months. In early stage breast cancer, it reduces the risk of cancer returning after surgery by an absolute risk of 9.5%, and the risk of death by an absolute risk of 3% however increases serious heart problems by an absolute risk of 2.1% which may resolve if treatment is stopped.
Pertuzumab, is a relatively new drug that can extend action of Herceptin (and is sometimes given in combination with it) and thus survival times for HER2 patients further.
Go to: Pertuzumab
At the moment Herceptin is licensed in the UK to treat advanced breast cancer in women who over-express the HER2 gene.
HER2 is a growth factor found on the surface of cells and plays a key role in regulating cell growth. Some 20 per cent of breast cancer cells have an excess amount of the HER2 protein on their surface, which makes the cancer more aggressive.
Thus Herceptin is not for every women, just the one in five who have this HER2 positive test result.
The over-expression of HER2 causes cells to grow, divide, and multiply more rapidly. Herceptin seeks out HER2 and attaches itself to the protein receptor on the surface of cells. By binding to the cells, Herceptin has been shown to slow the growth and spread of tumours that have this overabundance of HER2 protein receptors.
Herceptin originally received Big Press but some common sense needs to be applied. Recent studies covered in Cancer Watch, for example, show:
- It has been shown in studies to shrink tumours and extend womens survival by an average of about 13 months
- To repeat, it is applicable to about 20 per cent of breast cancer patients and does have a marked effect in approximately half of those.
- When treated with Herceptin prior to surgery 50 per cent of HER2 positive women show no signs of disease immediately after (M.D.Anderson, Texas)
- But resistance does occur to the drug. MD Anderson recommend all women are regularly tested during its usage and those that stop being HER2 positive come off it. A new drug is being developed to protect Herceptin and extend its effects.
- But there are natural bioactive compounds that will help you fight HER2+ breast cancer. For example: Researchers in Gerona have shown that phenolic compounds directly extracted from olive oil are effective against both HER2-positive and HER2-negative breast cancers cells. Polyphenols (especially those known as secoiridoids and lignans) found in extra virgin olive oil not only inhibited the activity of cancer-promoting HER-2 proteins but also promoted their degradation.
GO to: Natural Compounds that help fight HER2+ Breast cancer
Tyverb (or Tykerb in the USA) or Lapatinib, has been used with Herceptin on newly diagnosed patients in Clinical Trials and total euphoria has greeted the results. But patients in the UK, asking their oncologists following the claim that ’11 per cent of cancers disappear’, have been met with incredulity. Go To: US research on Tyverb
Herceptin Side-effects
The wonder drug, has side-effects and these can include: weakening of the heart muscle and heart problems, reduction of white blood cells (neutropenia), diarrhoea, anaemia, abdominal pain, infection or allergies. Some people who received Herceptin with Adriamycin (doxorubicin) particularly experienced heart problems, because of the cardiac toxicity of both drugs. This combination is no longer recommended.
There are some concerns about consuming grapefruit (as a fruit or juice) whilst taking Herceptin. Best to avoid.
Usage: Herceptin is usually given intravenously in the outpatients department.
Go to: 10 ways to improve your chemotherapy success and reduce side-effects
Other articles that you may find interesting are:
- A diet for Chemotherapy
- Immunotherapy overview
- A to Z Guide to Complementary Therapies
Go to: Return to the CANCERactive drug list