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Biological therapy for secondary breast cancer

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This page tells you about biological therapies for secondary breast cancer. There is information about

 

A quick guide to what's on this page

Biological therapy for secondary breast cancer

Biological therapies are treatments that stop signals that tell cancer cells to grow. Biological therapy can shrink secondary breast cancer or stop it from growing. It can keep it under control for some time. Treatments used in the UK for secondary breast cancer include Herceptin (trastuzumab), lapatinib (Tyverb) and denosumab (Prolia, Xgeva).

Herceptin (trastuzumab)

Trastuzumab is the most commonly used biological therapy for secondary breast cancer. It is a monoclonal antibody that attacks cells that make too much of a growth stimulating protein called HER2. Up to 3 out of 10 secondary breast cancers that have spread (30%) make too much of this protein. You have Herceptin by drip. You usually have it every week or every 3 weeks for as long as it keeps the cancer under control. It may be combined with chemotherapy or you may have it in trials with other biological therapy drugs. 

Lapatinib (Tyverb)

Lapatinib (Tyverb) is a type of cancer growth blocker. It stops breast cancer cells growing by blocking the activity of proteins called epidermal growth factor receptor 1 and HER2. You have lapatinib (Tyverb) as a daily tablet. You take it for as long as it is controlling the cancer. You may have it with other types of cancer treatment or in trials with other biological therapy drugs.

Denosumab (Prolia, Xgeva)

Denosumab (pronounced den-oh-sue-mab) is a type of monoclonal antibody. When cancer spreads to the bones it can weaken them and cause pain. Denosumab helps to strengthen the bones, which lowers the risk of fractures and helps to control pain. You have it as an injection just under your skin (subcutaneously). You have Xgeva every 4 weeks. Or you have Prolia every 6 months.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Secondary breast cancer section.

 

 

Types of biological therapy

Biological therapy is treatment that stops signals that tell cancer cells to grow. Herceptin (trastuzumab) is the main type of biological therapy used to treat secondary breast cancer. Doctors sometimes use lapatinib (Tyverb) alongside chemotherapy when other treatments have stopped working. A drug called denosumab (Prolia, Xgeva) can help to strengthen bones and reduce pain in women whose cancer has spread to the bone.

 

Trastuzumab (Herceptin)

Herceptin (trastuzumab) is a type of monoclonal antibody that attaches to breast cancer cells that have a large amount of a protein called HER2. It is also called trastuzumab. Up to 3 out of 10 breast cancers that have spread (30%) are likely to respond to treatment with Herceptin. 

HER2 protein is a growth factor receptor. It transmits signals from outside the cell to the inside, which make the cells grow. The Herceptin antibody attaches itself to this protein receptor and blocks it. So the receptor can no longer tell the cancer cells to grow. Herceptin also increases the effect of chemotherapy drugs on breast cancer cells.

You usually have Herceptin in combination with the chemotherapy drug paclitaxel (Taxol) if you have not had chemotherapy before for secondary breast cancer. 

If you have already had chemotherapy treatments for advanced breast cancer you may have Herceptin alone or in combination with other treatments such as chemotherapy or hormone therapy.

You have Herceptin into a vein, through a drip or central line. The first dose takes about an hour and a half. But after that you have it over 30 to 60 minutes each time. You have Herceptin every week, or every 3 weeks, for as long as it keeps your cancer under control. Doctors usually stop or change the treatment if the cancer starts to grow or spread again, unless it has only spread within the brain and spinal cord (the central nervous system). 

Some research seems to suggest that Herceptin may help some people to live longer even if the cancer continues to grow during treatment but we need more research to be sure. Research studies are looking at different ways of giving Herceptin. 

There is detailed information about the possible side effects of trastuzumab (Herceptin) in our section about specific cancer drugs.

 

Lapatinib (Tyverb)

Lapatinib (Tyverb) stops cancer cells growing by blocking the activity of 2 receptors – epidermal growth factor receptor 1 and HER2. You take it as a daily tablet. It is most commonly used alongside the chemotherapy drug capecitabine (Xeloda) for women with HER2 positive secondary breast cancer who have already had other treatments. You take it for as long as it controls the cancer.

There is information about the possible side effects of lapatinib (Tyverb) in our cancer drug section.

Trials in the UK are looking at giving lapatinib with other cancer treatments for women with secondary breast cancer that is HER2 positive. Trials are also looking at using lapatinib alongside Herceptin. You can find details of the trials on our clinical trials database. Type 'lapatinib' into the text box.

 

Denosumab (Prolia, Xgeva)

Denosumab (pronounced den-oh-sue-mab) is a type of monoclonal antibody. There are 2 brands – Prolia and Xgeva (pronounced ex-jeev-ah). When cancer spreads to the bones it can cause pain and weaken them. When the bones are weaker they break more easily. If your cancer has spread to your bones your doctor may suggest that you have denosumab. It can strengthen the bones to lower the risk of fractures and help to control pain. You have it as an injection just under your skin (subcutaneously).  

There is detailed information about denosumab including possible side effects in the cancer drugs section. You can find out more about controlling bone pain and weakened bones in this section.

 

Men with breast cancer

Herceptin research trials have only been carried out in women. So the National Institute for Health and Clinical Excellence (NICE) don't have the evidence necessary to recommend the use of Herceptin in men with breast cancer. You may still be able to have Herceptin if you have secondary breast cancer but it is not so clear how well it will work for you. There is more information about breast cancer in men in the breast cancer section.

 

Finding information and support

If you want to know more about biological therapy, you can talk to your doctor or the nurses involved in your treatment. There is general information in the main biological therapy section. You can also contact the Cancer Research UK nurses

There are books and booklets about biological therapy, some of which are free. Look at our breast cancer reading list.  

If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.

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Updated: 30 October 2012