Dramatic results in cancer testing

One of the world's leading medical journals is describing a new breast cancer drug as "simply stunning" and "maybe even a cure".

The New England Journal of Medicine said the results from the first trials of Herceptin on women with early stage breast cancer were "revolutionary, not evolutionary" and represented a "dramatic and perhaps permanent perturbation in the natural history of the disease, maybe even a cure".

It went on to say that the care of patients with HER2 positive breast cancer "must change today".

Medical journals rarely speak of a cure for cancer but trials of Herceptin found it reduced the risk of the cancer returning by 46 per cent.

The drug has already attracted attention in New Zealand. This week the Herald reported the case of Gisborne woman, Carol Mitchison, who faces a $104,000 bill for Herceptin treatment to improve her chances of survival.

Ms Mitchison, who had a mastectomy followed by months of chemotherapy and radiotherapy, was told the drug would boost her chances against the cancer returning by an extra 15 to 16 per cent. She urged health authorities to fast track its funding for more women.

About 2200 New Zealand women develop breast cancer each year and 640 die from it.

Up to 30 per cent of breast cancer patients have an aggressive cancer known as HER2 positive. Herceptin works on people sensitive to the protein HER2. In New Zealand the drug is only funded for women with advanced breast cancer but drug company Roche hopes to make it available to women with early stage cancer - possibly in about 14 months.

Headline results of a worldwide trial of the drug involving New Zealand patients were outlined in May. Doctors and breast cancer groups here labelled it "extremely exciting" and "absolutely outstanding".

The interim results were published in full for the first time this week.

The journal said no drug, not even tamoxifen - the gold standard in breast cancer for over 30 years - had shown such a significant reduction in risk in so short a time (one to 2 1/2 years).

New Zealand consumer group, Breast Cancer Advocacy Coalition, said the Government had a "moral and social obligation" to provide immediate interim "off label" funding for HER2 positive women while Herceptin went through the approval process for use and funding here.

Martine Piccart, who led the non-US study and who chairs the Breast International Group, said: "I cannot stress enough how crucial it is that all patients breast tumours are tested appropriately at initial diagnosis and if patients are HER2 positive that they have access to Herceptin.

The discovery that Herceptin only works in certain women demonstrates that breast cancer is not one but several diseases and marks a new era in cancer research. Instead of screening thousands of compounds to find one that works - the traditional mode of drug discovery - scientists are now designing drugs to target specific receptors identified as playing a role in cancer at the molecular level.

What is it?

A new breast cancer drug

How good is it?

A top medical journal says it may even cure breast cancer. Trials found it reduced the risk of cancer returning by 46 per cent.

How much does it cost?

A lot. Former health minister Annette King estimated the cost of fully subsidising the drug could be $300 million a year.

- INDEPENDENT and staff reporters