New hope for breast cancer sufferers

Researchers believe drug-and-detection combination will boost survival rates

In this story: 'Needle in haystack' 'Next leap forward' RELATED STORIES, SITES

By Douglas Herbert, CNN.com writer

LONDON, England -- Breast cancer researchers are testing a drug-and-detection treatment that they hope will help to pinpoint malignant cells and arrest their growth after surgery.

The assault on the disease, was unveiled by researchers at Hammersmith Hospital in west London, combines a potent new drug with a procedure that can spot a single cancer cell lurking among millions of normal cells in bone marrow.

Breast cancer is the second leading cause of cancer deaths among women, after lung cancer, and the risk increases with age. Obesity and heavy alcohol use are also considered aggravating risk factors.

In Britain, about 13,500 people died from the disease last year -- a great improvement over the 16,500 breast cancer fatalities recorded in 1992. At about this time British doctors began commonly prescribing the post-surgery drug Tamoxifen, which improves the cure rate of breast cancers caught in the early stages by about 20 percent.

Britain did not undertake a national screening program for breast cancer until 1994.

Professor Charles Coombes, the head of the team that conducted the latest research, said he had begun worldwide patient trials of a new drug, Exemestane, which he believes could boost survival rates by an extra 20 percent if used with Tamoxifen. The trials are expected to last from two to five years.

Coombes said his team had also begun a pilot study using a laser device, called Chromavision, taking bone marrow samples from 140 women and checking for the spread of cancer.

"Before, it was like looking for a needle in a haystack," Coombes said. "But now we should be able to pinpoint where cancer cells are growing." If the early-detection screening indicates further malignancy, he said, doctors would be able to prescribe Exemestane in early stages of the recurrence.

The new treatment, doctors say, takes aim at the Achilles' Heel of conventional breast cancer treatment: the failure of doctors using orthodox methods to detect smaller malignancies that are like ticking time bombs.

It also seeks to take some of the guess-work out of cancer treatment by offering patients a more precise method for monitoring the status of the disease after surgery.

"Until now, treating breast cancer has been like managing diabetes without checking a patient's blood sugar levels," Coombes said. "Doctors could never be sure how well Tamoxifen was working.

"This exciting new technology means doctors can now monitor women over a period of time to check whether Tamoxifen is working."

Dr. Lesley Walker of the Cancer Research Campaign, which announced the Hammersmith team's findings, said the treatment marked an important step forward.

"With Tamoxifen we never really knew whether it was working and if cells just survived. We've never been able to understand what was happening with the women who relapsed.

Dr. Walker added: "If we are going to make the next leap forward, we have to treat women as individuals ... this may be one of the most sensitive ways to pick up a problem. If you can identify a small number of cells in bone marrow, it may be a very sensitive approach ... we should be able to pick up those small clumps of cells which were really a death sentence in waiting."

Other researchers warned, however, against drawing too many early conclusions about the new treatment.

Professor Mitch Dowsett of the London-based Institute of Cancer Research called the Hammersmith trials "an encouraging development," adding that the automated testing will make laboratory work "easier and partly more reliable."

"However, a large clinical trial is needed to determine if this early detection of the spread of breast cancer makes the treatment more effective and saves lives ... at the present time this test cannot be advocated for routine use."

The Hammersmith trials come on the heels of findings by Italian researchers linking the likelihood of breast cancer recurrence to levels of a protein called maspin in bone marrow.

The research by Dr. Pier Francesco Ferrucci, of the European Institute of Oncology in Milan, suggested that women with high levels of maspin tended to remain free of breast cancer for two years. Those with lower levels of the protein in their bone marrow were seen as less likely to experience a recurrence.

About one in five women deemed by testing to be at low risk suffer a relapse of breast cancer.

The Associated Press contributed to this report.

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The Cancer Research Campaign
The Institute of Cancer Research
International Agency for Research on Cancer
The Hammersmith Hospitals NHS Trust

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