Breast cancer: Dr Chris on 'breakthrough' Enhertu drug
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In a world first, the new method could provide a non-invasive way to temporarily open the brain’s borders to allow tumour-fighting medication to target the cancer. The brain is shielded by a layer of specialized cells called the blood-brain barrier. It allows needed substances like oxygen and sugar in while keeping out toxic substances. But now, scientists have been able to use an advanced ultrasound technique to non-invasively, and temporarily, open the blood-brain barrier in patients who’s breast cancer had spread to their brains.
The study included four women with HER2-positive breast cancer which had spread to the brain.
In HER2-positive breast cancers, tumour cells carry a protein (HER2) that makes them grow.
But some drugs like trastuzumab (Herceptin) help to target that protein.
By opening up the brain borders temporarily, the Herceptin was able to target the patient’s brain tumours.
Using ultrasound with the assistance of MRI, if the blood-brain barrier shows up as plastic wrap, researchers said the technique “pulls apart” that plastic wrap at certain spots which gives the medication a port of entry to the brain.
That port of entry closes within 24 hours, the researchers said.
There were signs this technique increased the amount of the drug reaching the brain tumour.
But, according to researchers, the findings are preliminary and represent only a “proof-of-concept”.
Dr Nir Lipsman, Toronto-based senior researcher in the study and neurosurgeon at Sunnybrook Health Sciences Centre, said: “We’re at the first stage, showing this is feasible and safe.”
But the researchers said only a relatively small amount of Herceptin can penetrate the brain.
They said that, while this lays the groundwork for larger studies, it must be treated cautiously.
Dr Lipsman said the end goal is to find out whether the technique improves long-term control of brain tumour growth and can help prolong survival rates.
Dr Charles Shapiro, a professor and oncologist at the Icahn School of Medicine at Mount Sinai in New York, said a number of drug combinations, including Herceptin, do have “activity” against brain tumour in patients with HER2-positive breast cancer.
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He said that when cancer has spread to the brain, the blood-brain barrier is already “disrupted”.
The findings were published on October 13 in the journal Science Translational Medicine.
Breast cancer is highly treatable if it is caught early.
Among women diagnosed when the cancer is confined to the breast, 99 percent are still alive five years later.
That survival rate drops to 28 percent among women with metastatic breast cancer, which is when the tumour spreads to other parts of the body, like the brain.
One in seven women in the UK will develop breast cancer in their lifetime.
Around 55,000 women are diagnosed with breast cancer each year in the UK.
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