The new 'tumour-busting' drug that can shrink breast cancer cells in just six weeks

A new breast cancer drug can shrink tumours before surgery - making some 'disappear' in just six weeks - which may improve the chances of women surviving the disease, claim researchers.
Using lapatinib led to an average cut of 60 per cent in the size of the tumour and a fall in the number of stem cells that may help the cancer to spread.

Doctors hope the results mean there is less chance of recurrence in those women eligible to use lapatinib, around one in five of those struck by breast cancer including Jane Tomlinson, who died in September aged 43.

Findings from a US study released today led to calls for greater use of chemotherapy drugs in advance of breast cancer surgery, as well as afterwards.

By 'downsizing' the lump, some women can avoid having mastectomies while doctors gain valuable clues about the effectiveness of different types of chemotherapy in individual women.
In the latest study 45 women were treated with lapatinib before having surgery on large-sized lumps.

After six weeks of treatment, the tumours had gone into complete or near remission in two-thirds of women evaluated compared with one-quarter of women on standard chemotherapy.
But unlike standard treatment, lapatinib destroyed more stem cells with the capacity to self-renew which might protect women from the cancer coming back.
When a tumour goes into remission and 'disappears', surgeons still have to operate but they remove a much smaller area of tissue to check on whether the cancer cells have gone.
Further treatment such as chemo and radiotherapy is still necessary to deal with cells that may have already spread around the body.

Dr Angel Rodriguez, from the Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, who led the study, said the drug worked in the 20 per cent of women diagnosed with HER2 positive cancer - an aggressive form which can also be treated with Herceptin.
He said 'We saw significant tumour regression after six weeks of lapatinib.'
He said the drug reduced the ability of tumour-causing stem cells to replicate whereas conventional chemotherapy appeared to increase these cells.

He said 'We were excited to see that the results with lapatinib were different.
'Rather than the broad brush approach, in which cells are killed indiscriminately, targeting the stem cells may be more effective and also prevent some of the unpleasant side effects associated with conventional chemotherapy treatment.' Dr Rodriguez said it was too early to say whether the drug, also called Tykerb, might eventually be used to treat the majority of women whose cancers are not HER2 positive.

'International studies are currently underway looking at the effect of lapatinib in lung, colon, head and neck, gastric, oesophageal, and bladder cancer and lymphoma, among others' he added. The results were released at the European Breast Cancer Conference in Berlin.
Professor Emiel Rutgers, a leading Dutch breast cancer surgeon, said the findings should encourage more surgeons to use 'up-front' chemotherapy to reduce the size of tumours before operating.

He said 'This type of treatment is under-utilised yet it not only means a better cosmetic result from surgery but also shows the response of the patient to chemotherapy.'
Previous studies show lapatinib can halve the speed of growth of cancer, giving women precious extra months of life.

It is licensed in the US and is going through licensing procedures in Europe, where the drug safety body will next week look at new data on possible liver side effects before deciding whether to confirm its 'positive opinion' on the drug.

The final stage of approval will be given by the European Commission.
In the UK the Government's 'rationing' body the National Institute for Health and Clinical Excellence (NICE) will have to decide whether the NHS can afford the £6,800 price tag.
Despite being fast-tracked, this process could still take four to five months and until then doctors have to win funding for individual patients from local primary care trusts.

Mrs Tomlinson lost her seven-year battle with cancer after raising more than £1.75 million for charity in gruelling endurance events, including three London Marathons.
She had to travel from her home in Leeds to Nottingham to receive lapatinib because Leeds Teaching Hospitals NHS Trust had not taken part in an expanded access programme for the treatment.

The programme made the drug available before licensing, with drug costs paid by the manufacturer GlaxoSmithKline.

A GSK spokesman said its own safety review resulted in data showing a 'rare' incidence of 0.4 per cent of liver problems in users, which were picked up by routine monitoring and resolved after patients stopped taking the drug.

A spokesman for NICE said lapatinib was being fast-tracked through its review process.
She said 'We have gone as far as we can before the drug gets a licence but we may be able to issue a recommendation within a month subject to appeal.
'The quickest we can complete the process is four to five months' she added.

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