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About targeted drug treatment for advanced cancer

There are a few different types of targeted drug treatments for advanced breast cancer. Some target a particular part of the cancer cell others use the immune system to kill cancer cells.

Targeted cancer drugs are treatments that change the way cells work and help the body to control the growth of cancer.

Our immune system works to protect us against diseases, including cancer. It normally picks up faulty cells and destroys them. Sometimes the immune system misses these and cancer develops. Scientists are working on ways to trigger the immune system so it can target cancer cells.

How you have them

You can have targeted drugs as:

  • a drip in your arm
  • an injection under the skin
  • a tablet

Trastuzumab

Trastuzumab is a targeted cancer drug and is also known by its brand name, Herceptin.

It is a treatment for cancers that have large amounts of a protein called human epidermal growth factor receptor 2 (HER2), such as:

  • early breast cancer
  • advanced breast cancer
  • advanced stomach cancer

Up to 3 out of every 10 people with advanced breast cancer (30%) have HER2 positive breast cancer. A sample of your tumour (biopsy) will show if it's HER2 positive. 

You have trastuzumab as a drip into your bloodstream (an infusion) or an injection under the skin (subcutaneous injection).

You might have trasuzumab:

  • on its own
  • with chemotherapy such as paclitaxel, or hormone therapy
  • with chemotherapy and another targeted drug called pertuzumab
  • with other drugs as part of a clinical trial

Pertuzumab (Perjeta)

Pertuzumab targets the HER2 protein but blocks a different part of the protein than trastuzumab. 

You have pertuzumab as a drip into your vein.

You have pertuzumab with trastuzumab and a chemotherapy drug called docetaxel. The organisations within the UK that decide which treatments should be available within the NHS have approved it for people:

  • who have HER-2 positive breast cancer that has spread
  • whose cancer has come back in or near the breast and surgery isn't possible
  • who haven't previously had anti HER-2 treatment or chemotherapy for their advanced breast cancer

Doctors are waiting for the results of several trials looking at pertuzumab with different drugs for advanced breast cancer.

Denosumab (Prolia, Xgeva)

Denosumab is a type of monoclonal antibody.

When cancer spreads to the bones it can cause pain and weaken them. Your doctor may suggest 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). You usually have once it every 4 weeks.

Everolimus (Afinitor)

Everolimus is a type of cancer growth blocker. It stops some cancer cells from dividing and growing.

You take it as a tablet.

You have this drug if you are past the menopause (post menopausal). You take it with a hormone therapy drug called exemestane.

Palbociclib (Ibrance) and similar drugs

Palbociclib, ribociclib (Kisqali) and abemaciclib (Verzenios) are all a type of targeted drug called a cancer growth blocker. They block the proteins CDK4 and CDK6 which tell the cell to grow and divide. These can become overactive when there are too many hormone receptors. This can happen with advanced breast cancer.

These drugs can help to control the growth of breast cancer cells and slow it down. This is a treatment for hormone receptor positive advanced breast cancer. It is only for women who have not had hormone treatment before. Your cancer must also be HER negative, this means that drugs such as trastuzumab (Herceptin) wouldn’t work. 

You have one of these drugs with hormone therapy called an aromatase inhibitor, e.g. letrozole. The National Institute for Health and Care Excellence (NICE) have decided that these 3 drugs work as well as each other, but they have different side effects. Your doctor can tell you if the drug is suitable for you. 

You have palbociclib and ribociclib as tablets taken every day for 21 days and then you stop taking it for 7 days. This is one cycle of treatment. Then you start the next cycle. You have abemaciclib every day without a break.  

Trastuzumab emtansine

Trastuzumab emtansine is a combination of 2 drugs - trastuzumab and emtansine. It is also known by its brand name, Kadcyla (pronounced cad-sigh-lah].

It is a treatment for HER2 positive breast cancer that has come back or spread to other parts of the body. You usually only have it if you have had treatment with trastuzumab (Herceptin) and a drug known as a taxane.

You have it into your bloodstream (intravenously) every 3 weeks. 

Targeted drug treatments for men with breast cancer

Because breast cancer is very rare in men, research trials into targeted drugs for breast cancer have only been carried out in women. So we don't know how well they work in men. 

But you may still be able to have targeted drug treatment.

Research

Researchers are looking at different types of targeted drugs for advanced breast cancer.

The drugs are being combined with chemotherapy or other types of drugs to see if they improve how well they work as a treatment.

Side effects

The side effects of targeted drugs vary according to the particular drug you are having. You may have a few side effects. They can include:

  • an allergic reaction
  • diarrhoea
  • tiredness
  • flu-like symptoms including fever, muscle aches and sickness
  • low blood counts

Tell your doctor or nurse if you have any side effects.

When you go home

Treatment with targeted drugs for advanced breast cancer can be difficult to cope with. Your nurse will give you numbers to call if you have any problems at home.

It is important to contact them as soon as possible if you have side effects.

For general information you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open Monday to Friday, from 9am to 5pm.

Information and help

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