Tuesday, July 28, 2009

IBC triple negative treatment?

What's the most current thinking on treating triple-negative IBC? Also, early trial results on Tykerb indicate positive results for IBCers. How does that translate to triple-negative IBCers?
Probably about 40% of inflammatory breast cancers are likely to be triple negative. Those tumors that are triple negative are today treated with a combination of chemotherapy, surgery, and radiation. We have no evidence that any additional treatment is useful. Lapatinib, or Tykerb, is a drug that was developed specifically for tumors that have excess amounts of two specific proteins: HER1 and HER2. It does have anti-tumor activity, and its activity appears especially prominent in those patients that have HER2 abnormalities. In that sense, it is similar to Herceptin in its spectrum of activity. The initial trials with Tykerb that included just a small number of patients with inflammatory breast cancer suggest that Tykerb in the HER2 positive inflammatory breast cancer group was active in 1 in 3 patients. To the best of my knowledge, Tykerb has not been tested in the triple-negative group, nor is there a reason to do so at this time. Until Tykerb becomes commercially available, the treatment of choice for patients with inflammatory breast cancer that have HER2 abnormality would be Herceptin, or trastuzumab, in combination with chemotherapy as well as surgery and radiation therapy.

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