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Biological therapy for breast cancer

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This page is about biological therapies for early breast cancer and there is information about

 

A quick guide to what's on this page

Biological therapy for breast cancer

Biological therapy is treatment that changes the way cancer cells interact and stops them sending signals that make them divide and grow. 

Herceptin (trastuzumab)

Herceptin is the most commonly used biological therapy for breast cancer. It can reduce the chance that the cancer will come back after surgery. Between 20 and 25 out of every 100 patients with early breast cancer (20 to 25%) are likely to respond to treatment with Herceptin. Their cancer cells have large amounts of a protein called HER2 or erbB2. Herceptin blocks signals from the protein that tell these cancer cells to grow. Herceptin also increases the effect of chemotherapy drugs on breast cancer cells. 

Other biological therapies

Other types of biological therapy are used for breast cancer that has spread or come back. These include lapatinib (Tyverb), pertuzumab (Perjeta), and everolimus (Afinitor). We have information about these on our page about biological therapy for secondary breast cancer.

Research into biological therapies

Researchers are looking at other drugs in clinical trials, such as saracatinib, rucaparib, neratanib, trastuzumab emtansine, dasatinib, and genetespib. In some trials particular drugs are combined with chemotherapy to see if they improve the results of treatment. You can find details of these trials on our clinical trials database.

 

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

 

 

Types of biological therapy for breast cancer

Biological therapy is treatment with drugs that change the way cancer cells interact and stops cancer cells sending signals that make them divide and grow. Trastuzumab (Herceptin) is used to treat early breast cancer. It can reduce the chance that the cancer will come back after surgery.

Other biological therapies are used for breast cancer that has spread or has come back after initial treatment. They include lapatinib (Tyverb), pertuzumab (Perjeta) and everolimus (Afinitor). We have information about biological therapies for advanced breast cancer.

Other types of biological therapy are being used in clinical trials.

 

Herceptin (trastuzumab)

Herceptin (trastuzumab) is the most commonly used biological therapy for breast cancer. It is a type of monoclonal antibody that attaches to a particular type of protein. Some breast cancer cells have a lot of this protein and are called HER2 positive. The protein is a growth factor receptor. It transmits signals from outside the cell to the inside, which make the cells grow. Herceptin attaches itself to these protein receptors and blocks them. Then they can no longer tell the cancer cells to grow. Herceptin also increases the effect of chemotherapy drugs on breast cancer cells.  

Somewhere between 20 and 25 out of every 100 patients with breast cancer (20 to 25%) are HER2 positive and likely to respond to treatment with Herceptin. 

Testing whether trastuzumab is suitable for you

When you are diagnosed with breast cancer, doctors use a test called immunohistochemistry (IHC) to test the level of the HER2 protein in the tumour sample. The test grades your HER2 level between 0 and 3+. 

If the level is 0 to 1 you have low levels of HER2 and won't benefit from Herceptin.

If the level is 2+, your doctors will do a more accurate test called fluorescence in situ hybridisation (FISH testing). This test looks for a gene called HER2/neu that makes the cell produce the HER2 protein. If the amount of the gene is high (called gene amplification) you will benefit from Herceptin treatment.

If the level is 3+, you have high levels of HER2 and will benefit from Herceptin 

About treatment with trastuzumab

The National Institute for Health and Care Excellence (NICE) has recommended Herceptin as a treatment option for women with HER2 positive early breast cancer after surgery and chemotherapy (and radiotherapy if needed). You have Herceptin every 3 weeks for a year. 

The guidance says you should not have Herceptin if you have any of the following heart problems

  • Congestive cardiac failure
  • Angina that you take medicines for
  • Uncontrolled high blood pressure
  • Evidence of a heart attack on a heart trace (ECG)
  • Heart valve disease that is causing physical effects
  • Certain abnormal heart rhythms, that are uncontrolled

If Herceptin is suitable for you, you have tests on your heart before you start treatment and every 3 months throughout your course of treatment. If there is any sign that Herceptin is causing heart problems, your doctor may recommend that you stop the treatment. You may also stop treatment if your breast cancer comes back at any point during the year of treatment.

 

Side effects of trastuzumab (Herceptin)

The side effects of trastuzumab (Herceptin) can include 

  • A reaction while the drug is given
  • Soreness at the injection area if you have trastuzumab as an injection under the skin
  • Tiredness and weakness (fatigue)
  • Skin rashes 
  • Diarrhoea
  • Bruising more easily due to a drop in platelets
  • Numbness or tingling in the fingers and toes 

We have detailed information about the side effects of trastuzumab (Herceptin)

 

Men with breast cancer

Herceptin (trastuzumab) has been licensed for use in people with early breast cancer. But the research has only been carried out in women. So NICE don't have the evidence necessary to recommend the use of Herceptin in men with early breast cancer. You may still be able to have it but unfortunately it is not clear how well it will work. 

There is detailed information about breast cancer in men in this section. Because breast cancer in men is very rare it is also difficult to know how well other types of biological therapy will work.

 

More information about biological therapies

Look at the main biological therapy section for detailed information. You can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

You may also like to contact one of the breast cancer organisations. They often have books and leaflets, some of which are free. We also have details of breast cancer books and leaflets.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 2 August 2014