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A Cancer "Smart Bomb" - New Treatment Option for Some Late-Stage Breast Cancers

For the past several years, medical oncologist Neelima Denduluri, MD has been involved in clinical trials testing a promising new drug called T-DM1 that targets the cancer cells of certain breast cancers. Earlier this year, the Food and Drug Administration approved T-DM1 for patients with HER2-positive, metastatic breast cancer who are no longer responding to the standard treatment regimen of Herceptin® and chemotherapy.

What is HER2-Positive Breast Cancer?

HER2 is a protein involved in normal cell growth. In about one-sixth of breast cancer patients, increased amounts of the HER2 protein are found on some types of cancer cells, known as HER2-positive cells. When this occurs, HER2 acts like a fertilizer, promoting cancer cell growth.

How does T-DM1 work?

T-DM1 is Herceptin, or trastuzumab, connected to a drug called DM1, which interferes with cancer cell growth. With T-DM1, the drug goes straight to the cancer site to shrink the tumor, slow disease progression and prolong survival.

Why is T-DM1 considered a “smart bomb”?

Unlike a typical bomb which destroys everything in its path, a smart bomb locks on to what it is supposed to destroy and leaves surrounding structures undamaged. One of the biggest drawbacks of many chemotherapy drugs is that along with killing cancer cells, they kill healthy cells, too. That’s why patients often have side effects with chemotherapy. T-DM1 is more likely to target the cells with increased HER2 with less damage to healthy cells than conventional chemotherapy. As a result, patients tolerate it much better.

What results have you seen with T-DM1?

For the past five years, I have prescribed T-DM1 for many patients who have come from across the country to participate in the clinical trials. It was very refreshing to see how effective it was for some patients. Compared to other chemotherapy drugs, my patients experienced fewer side effects, including minimal nausea. Plus, with T-DM1, there is no hair loss.

Is T-DM1 an option for all breast cancer patients?

No. T-DM1 is only approved for patients with HER2-positive metastatic breast cancer who have been treated previously with Herceptin and chemotherapy. T-DM1 offers these women another option when standard treatment regimens are no longer effective. This kind of highly targeted cancer therapy is the wave of the future.


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