Thursday, August 31, 2006


Well the Alberta government has finally seen fit to make Herceptin available to all breast cancer patients who would benefit from this drug.

For more info on Herceptin, check out this excellent article from the CBC (Canadian Broadcasting Corporation, web site:

The promise of Herceptin
Last Updated August 30, 2006
CBC News

When the government of Alberta announced that it would begin picking up the tab for the breast cancer drug Herceptin for patients in all stages of the disease, it became the last province to do so.

Before the Aug. 28, 2006 announcement, Alberta covered the cost of the drug only for people in the advanced stages of breast cancer treatment. That's what the drug was approved for by the U.S. Food and Drug Administration in 1998. And it had proven quite effective in lengthening the lives of women in the late stages of breast cancer.

Herceptin therapy can cost $40,000 a year per patient. Alberta's health minister — Iris Evans — estimates the move will cost the province about $8 million a year.

"I'm very satisfied that the clinical trials have given strong evidence that this is an important therapy for us to use," she said.

Most provinces began paying for the drug for patients in the early stages of breast cancer a year before Alberta's move. Evans said the province wanted to wait until clinical trials were complete before making the same decision.

For advocates of the therapy, the evidence of Herceptin's effectiveness had been indisputable long before Alberta agreed to follow the lead of the other provinces.

Herceptin is an antibody that binds to a protein on human skin cells — the human epidermal growth factor receptor 2 (HER2). It is believed an excessive amount of this protein increases breast cancer growth — and increases the risk of recurrence of the disease and death.

Approximately 25 per cent of patients have this aggressive form of breast cancer.

In May 2005, three large-scale studies of the drug were abruptly halted because of overwhelmingly positive results.

The studies showed the rate of breast cancer recurrence was reduced by more than half when Herceptin was given to women undergoing chemotherapy compared to women who received traditional chemotherapy alone.

Among the findings:

* After two years, there were 261 events (such as return of the cancer, second primary cancer or death before recurrence) in the control group and 133 events in the group taking Herceptin.

* After three years, 87.1 per cent of patients taking Herceptin were alive and disease-free compared to 75.4 per cent in the group not taking Herceptin. After four years, 85.3 per cent of patients on Herceptin were still alive and well compared to 67.1 per cent for those on standard chemotherapy.

* Women taking Herceptin with a particular chemotherapy regimen had a 33 per cent reduction in risk of death.

Dr. Brian Leyland-Jones of Montreal's McGill University was the lead author on one of the studies. He called Herceptin the most important advance in breast cancer therapy in 30 years.

He noted that in traditional breast cancer therapy, one in four women will see their cancer spread sometime after undergoing surgery. In the Herceptin studies, that number dropped to one in 10.

"We're not quite sure [how Herceptin works]," Leyland-Jones said. "There are different factors that stimulate the growth of cells in your body. The targeted therapy interferes with the binding of this stimulating growth factor."

In October 2005, the New England Journal of Medicine reported on the three clinical trials. In an editorial, the Journal called the results "revolutionary."

"The results are simply stunning. With very brief followup (one to two and a half years), all three trials show highly significant reductions in the risk of recurrence of a magnitude seldom observed in oncology trials," the editorial said.

As many as 5,000 Canadian women a year stand to benefit from early use of Herceptin.

There is one significant side-effect. There is a small risk of heart damage in women undergoing Herceptin treatment. Approximately one woman in 200 could suffer heart damage.

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