August 24, 2007 (Insidermedicine) A new vaccine to treat metastatic breast cancer shows promising safety results, according to a report published in the Journal of Clinical Oncology.

Here are some important points regarding the management of breast cancer:

•    Diagnosis of breast cancer involves so-called "triple assessment"- consisting of: clinical evaluation, imaging and tissue sampling in a designated breast clinic.
•    Initial therapy should include consideration of breast conserving surgery (excision of tumour with clear margins) or modified radical mastectomy. Consideration should also be given for adjuvant radiation and chemotherapy.
•    Herceptin should be considered  for those patients whose tumours have HER-2 over-expression.
•    Neoadjuvant chemotherapy should be considered for women with large cancers as it improves the rate of breast conservation and is not detrimental to long term outcome.

HER-2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor-2, which promotes the growth of cancer cells. It makes up about 20% to 30% of all breast cancer cases.

New therapies are being developed to extend the survival of women with breast cancer, including a new vaccine called Neuvenge. It is an autologous active cellular immunotherapy prepared from peripheral-blood mononuclear cells, including antigen-presenting cells.

In a study to assess its safety, 18 women were given one of three doses of the vaccine, in addition to prior treatment with Herceptin, a drug that has shown to prolong survival in women with HER-2 positive breast cancer. Patients underwent a physical exam and laboratory testing at intervals, starting at the beginning of the study through 48 weeks.

Four out of the 18 patients either stabilized or improved, with over half developing fever and chills. The researchers say that this therapy is feasible in patients with advanced breast cancer, but more research is needed to determine if it can prolong survival.

While the vaccine is still in the developmental stage, two clinical trials involving a similar vaccine for prostate cancer- called Provenge- showed evidence of stabilizing the disease. The vaccine, however, was not granted immediate FDA approval as it has not been shown to definitively affect survival.

For Insidermedicine in Depth, I'm Dr. Petra Joller.