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Biological therapies| are newer drugs that work differently from chemotherapy| drugs. There are different types of biological therapies, which work in slightly different ways. They can be used alone or in combination with chemotherapy or hormonal therapy.|
At the moment, Herceptin®| is the only biological therapy that has been approved by the National Institute for Health and Clinical Excellence (NICE|) to treat secondary breast cancer. NICE advises the NHS on what new drugs and treatments should be available to patients.
Lapatinib (Tyverb®)| and bevacizumab (Avastin®)| are other biological therapies, which can be used to treat secondary breast cancer but haven’t been approved by NICE. They aren’t widely available on the NHS but you may be offered these drugs within a clinical research trial|. Other biological therapies are also being given in clinical trials.
Herceptin (trastuzumab) is the main biological therapy used to treat secondary breast cancer in women whose cancers have high levels of the HER2 protein|. Around 1 in 5 (20%) of women with secondary breast cancer have a large number of receptors - this is known as being HER2 positive.
Herceptin works by interfering with one of the ways breast cancer cells divide and grow. Some breast cancer cells divide and grow when a protein called human epidermal growth factor attaches itself to another protein known as HER2.
The HER2 protein is found on the surface of some breast cancer cells.
Herceptin blocks this process by attaching itself to the HER2 protein so that the epidermal growth factor can’t reach the breast cancer cells. This stops the cells from dividing and growing.
Herceptin is usually given once every three weeks as a drip (infusion). It can be given alone or in combination with chemotherapy or hormonal therapy. Your cancer specialist will explain the most appropriate way for you to have it.
The side effects are often mild but some women may have:
In some women, Herceptin may cause damage to the heart and if this happens Herceptin is stopped. Herceptin isn’t given to women with serious heart problems.
If secondary breast cancer continues to grow in areas outside the brain and spinal cord (central nervous system) Herceptin is usually stopped. But if the cancer starts to grow in the central nervous system (CNS), treatment with Herceptin can continue. This is because Herceptin doesn’t work for secondary cancer in the CNS but may carry on working to control secondary breast cancer in other parts of the body. Other treatments can be used to control the cancer in the CNS.
Lapatinib is a newer drug that can also be used in women with HER2 positive breast cancer. It belongs to a group of drugs known as tyrosine kinase inhibitors (TKIs)|. Some cancer cells have proteins called growth factor receptors on their surface. These receptors activate a protein inside the cell called a tyrosine kinase enzyme, which can encourage the cancer cell to grow. Lapatinib helps to control the cancer by blocking this enzyme.
Lapatinib is given as a tablet and can be given in combination with the chemotherapy drug capecitabine (Xeloda®)|, or with an aromatase inhibitor in postmenopausal women.
Bevacizumab| is also a monoclonal antibody. It works by stopping the cancer from developing new blood vessels.
This reduces the cancer’s supply of oxygen and nutrients, which may shrink the tumour or stop it growing.
Content last reviewed: 1 September 2010
Next planned review: 2013
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© Macmillan Cancer Support 2013
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