Heart problems induced by a breast cancer drug could be prevented
Breast cancer is one of the most common cancers among women worldwide. There have been significant advances in live-saving treatments against breast cancer in the past few decades. These advances bring new hope to women with breast cancer. During drug development, the ideal case may be that a drug treats or cures the disease effectively without causing any side effects. But, the fact is that many clinically used drugs can come with unwanted side effects and complications. The breast cancer drug, Herceptin, is good at cutting the chance of cancer relapse and improving patient outcomes. However, around a quarter of breast cancer patients who receive Herceptin will experience some type of heart problem, and more and more studies have confirmed that Herceptin can damage the heart.
Recently, scientists have found a promising way to resolve heart problems induced by Herceptin treatment. The study was led by Professor Maya Guglin from the Gill Heart & Vascular Institute of the University of Kentucky. In the study, Professor Guglin, her colleagues, and their collaborators tested whether two groups of drugs, ACE inhibitors and beta blockers, could help protect heart function of patients undergoing chemotherapy. They found that ACE inhibitors and beta blockers did not preserve ejection fraction (a general measure of a person's heart function) in patients who received Herceptin alone. By contrast, in patients who received doxorubicin before Herceptin, ACE inhibitors and beta blockers appeared to reduce heart damage.
These results indicated that the use of ACE inhibitors or beta blockers may be an approach to reducing the risk of heart problems, at least in some of the breast cancer patients, and that breast cancer patients receiving both doxorubicin and Herceptin may benefit from ACE inhibitors and beta blockers.
Findings of the study were presented in the American College of Cardiology (ACC) 67th Annual Scientific Session & Expo, which is held during March 10 - 12, 2018 at Orlando, Florida, United States of America.
Herceptin is specifically used to treat breast cancer that is Human Epidermal growth factor Receptor 2-positive (HER2+). The HER2 gene codes for HER2 proteins
, which help control the growth and repair of breast cells. Overexpression of HER2 contributes to the development and progression of breast cancer. HER2+ breast cancers, which account for about one-fifth of all breast cancer cases, are usually more aggressive than other types of breast cancer.
Since Herceptin was approved for medical use in 1998, the drug has been used as a HER2+ breast cancer treatment for two decades. The drug may be one of the most effective treatments for this type of breast cancer. However, the side effects and complications caused by it, such as heart problems, begin to limit its applications. So, scientists including Professor Guglin want to find ways to preserve the heart function of patients receiving this drug. Now, Professor Guglin's study provides a solution: ACE inhibitors or beta blockers.
Further, the new study highlights the need to rethink the treatment of HER2+ breast cancer. There are still many questions that have to be answered. For instance, whether Herceptin should be used in combination with doxorubicin remains unclear.