4 things to know about T-DM1, the new breast cancer “smart bomb”

Wednesday, June 6, 2012

The experimental drug, T-DM1, also known as the breast cancer “smart bomb,” is a phrase that’s been on everyone’s lips and search engines since Monday when it was announced as the “miracle drug” breast cancer treatment.

Dr. Kimberly Blackwell, an oncologist at Duke University Medical Center and lead investigator of the T-DM1 study, presented her findings at the annual meeting of the American Society for Clinical Oncology in Chicago this weekend. The study compared the T-DM1 treatment to the standard chemotherapy regimen in women with stage 4 HER2-positive breast cancer. The study found that T-DM1 lengthened the “time to progression” rate—the amount of time until the patients’ cancer started to grow.

Currently, the standard treatment for women with HER2-positive breast cancer is Trastuzumab, better known as Herceptin® combined with chemotherapy.

But is T-DM1 really a “magic bullet” for women with breast cancer? Is this the cure we’ve been waiting for? John Pippen, M.D., clinical oncologist on the medical staff at Baylor Charles A. Sammons Cancer Center in Dallas, says while it’s not a cure, it’s certainly promising for the fight against breast cancer.

According to Dr. Pippen, these are the four most important things you should know about T-DM1:

1.)    T-DM1 treatment is not FDA-approved…yet. T-DM1 is still being tested in clinical trials; however, experts are hopeful it will be approved within the next year. “Our hope is that this treatment is fast-tracked through the FDA approval process. We are cautiously optimistic that it will continue to show positive results and fewer side effects,” says Dr. Pippen.

2.)    T-DM1 doesn’t have the same side effects as traditional treatments. The study reported that patients in the T-DM1 clinical trial didn’t lose their hair or experience nausea, common side effects of traditional chemotherapy. “What makes T-DM1 so different is that it is a combination of Herceptin® and a potent chemotherapy known as emtansine, or DM-1. By itself this chemotherapy can be harmful, but in the T-DM1 treatment, it isn’t released until it reaches the exact target in the cancer cell. It doesn’t affect every other cell in the body like traditional chemotherapy does. That’s why this treatment is being called a ‘smart bomb’,” explains Dr. Pippen. “T-DM1 won’t necessarily make chemotherapy obsolete. It will be complimentary to it.” However, according to the study results, T-DM1 may cause other side effects such as inflammation of the liver.

3.)    T-DM1 doesn’t work against all forms of breast cancer. There are many types of breast cancer, HER-2 positive being only one of them and accounting for about 20% of all breast cancer cases. But why does this treatment work on HER2-positive and not other types of breast cancer? Dr. Pippen says it’s because HER2-positive is an easy target compared to more complicated types, like triple-negative breast cancer. “HER2-positive is a type of breast cancer that tests positive for human epidermal growth factor receptor 2 (HER2), which contributes to the growth of cancer cells. This protein lends itself to targeted treatment because it is displayed on the surface of the cancer cell. It’s easier to find.”

But this isn’t the first time HER2-positive breast cancer has been weakened by a breakthrough treatment. Herceptin®, the popular drug used to treat HER2-positive breast cancer, was approved by the FDA in 1998. Prior to that time, HER2-postive was considered one of the deadliest forms of breast cancer.

4.)    Treatments like T-DM1 are the future of cancer treatment. The standard treatment for breast cancer has historically been a “one size fits all” approach, according to Dr. Pippen. But that approach is changing thanks to the technology used in treatments like T-DM1. “What we’re doing now is trying to figure out what makes cancer tick. What is driving it? Then we target and attack that piece of the cell. That’s the goal of targeted cancer treatments like T-DM1. They go straight to the source.”

If breast cancer is now being treated with so-called “smart bomb” drugs like T-DM1, what could be next? Dr. Pippen says we can expect even more sophisticated approaches in the future.

“I look for nanotechnology treatments. One day, we could inject nanoparticles into a person with cancer and use a smart phone app to detect the cancer cells. This is just an example of how amazing the technology is today. Anything is possible.”

Dr. Pippen explains more about the T-DM1 study in this segment from KTVT-CBS 11.

This blog post was contributed by Ashley Howland, social media manager, Baylor Health Care System. 

 

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