Unlocking Herceptin's potential against esophageal cancer

December 20, 2014 | by Hiu Chung So

The protein HER2 is most commonly associated with breast cancer, but it also plays a role in several other cancers — including  esophageal cancer. Using this knowledge and the drug trastuzumab (Herceptin), which targets HER2, City of Hope researchers are conducting clinical trials with the hope of improving survival and quality of life for this hard-to-treat disease.

HER2 and trastuzumab Trastuzumab (Herceptin), colored blue in the above model, is well-known for treating HER2+ breast cancer, but it has potential for detecting and treating esophageal cancer, too.

 

The overall five-year survival rate for esophageal cancer is a dismal 17.5 percent, according to the National Cancer Institute. Further, because this cancer rarely shows symptoms in its early stages, it is usually not detected until it has progressed to more advanced and less curable stages.

But like breast cancer, some esophageal cancers have an overexpression of the gene that makes HER2, a growth factor that drives tumor development and spread. By blocking HER2 with drugs such as trastuzumab, researchers hope that HER2-overexpressing esophageal cancers can be treated just as successfully as HER2-positive breast cancers.

Already, trastuzumab has shown promising results in early trials and City of Hope is part of a multicenter phase III study to determine whether adding this drug to the standard treatment of radiation and chemotherapy is better than standard treatment alone. The trial is still currently recruiting patients at City of Hope and is planned for completion by the end of 2018.

In a separate study led by Vincent Chung, M.D., associate clinical professor in City of Hope's Department of Medical Oncology & Therapeutics Research, researchers are investigating whether HER2 overexpression can be exploited to be better detect the disease.

In this trial, trastuzumab is linked to a imaging agent called 64Cu-DOTA. Because HER2-overexpressed cancer cells take in more trastuzumab than normal tissues, they will also absorb more of the 64Cu-DOTA as well, allowing for better visualization of tumors in a positron emission tomography, or PET, scan.

Chung and his colleagues will be comparing this method to standard scanning procedures to see if it results in superior tumor imagery, which can help clinicians better locate cancer sites, find out if current therapies are working and plan for future treatments. This trial is also currently recruiting for patients and is expected to conclude by the end of 2015.

If both of these studies pan out with positive results, trastuzumab may be hailed once again as a breakthrough lifesaver, echoing its praises when it first debuted for breast cancer patients in 1998.

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Learn more about City of Hope's treatment and research for esophageal cancer.

Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.

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