Treatment tested for first time in the world on
patients in terminal stages of HER-2 breast cancer
A new
cancer treatment being tested for the first time in the world in Singapore
could bring hope to women suffering from tough-to-treat breast cancer.
Such women
include Madam Goh, who was first diagnosed with breast cancer in 1999 at the
age of 39. After initial treatment, she led a normal life until 2011, when the
cancer returned with a vengeance. It had spread to the rest of her body,
including her liver and lungs.
Her
oncologists at the National Cancer Centre tried one treatment after another to
stop it but with little success. Last year, having run out of options, they
referred her to the National University Cancer Institute Singapore (NCIS) as
they knew of an ongoing trial there.
In the
trial, doctors use the body's natural killer cells (NK cells) to stop the
progression of late-stage breast cancer.
Madam Goh
underwent treatment between Septemberlast year and March. The 56-year-old
mother of two, who declined to give her full name, said: "My appetite has
returned and I feel like a normal person now."
NK cells
have been used for some time to fight cancer, but usually for liquid cancers
such as leukaemia.
The trial
was the first attempt to use them in patients in the terminal stages of human
epidermal growth factor receptor 2 (HER-2) breast cancer, which accounts for
about one in four breast cancers here.
The
results of the clinical trial at NCIS were presented at one of the top cancer
meetings in the United States last month.
Dr Lee
Soo Chin, a senior oncologist researcher at NCIS and the principal investigator
in the trial, said there is now a follow-up trial using higher levels of NK
cells. It is hoped that this could lead to longer progression-free survival.
If all
goes well, the treatment could go into clinical practice for early stage HER-2
patients who face a high risk of the cancer recurring.
NK cells
are part of a body's immune system but, in cancer patients, the level of NK
cells is usually low. The trial took the NK cells out of the patients' blood,
multiplied the numbers by about 350 times in a cell culture, made them more
potent through a patented process, then put them back in the body.
Patients
were also given Herceptin, a very potent standard drug to treat HER-2 breast
cancer. Besides killing cancer cells, this drug increases NK cells' ability to
fight the cancer. That is why the trial is meant for only this kind of breast
cancer.
The whole
treatment costs about $50,000.
All of
the trial's 14 patients, such as Madam Goh, had exhausted all available
treatments, with one having undergone 13 different treatments.
The first
three patients were given one million NK cells per kg of their weight. When it
was found to be safe, the next 11 were given the target 10 million NK cells per
kg.
Dr Lee
said the median progression-free period of 6.3 months is very good as most
other treatments keep the cancer at bay for two months or less. The longest
progression-free survival so far is nine months.
She has
started two patients on a dose of 50 million NK cells per kg of body weight,
with plans to double that dose in the hope that higher doses could lead to
longer survival. The treatment is well tolerated, and patients enjoy a good
quality of life.
This has
been the case for Madam Goh. She has been travelling, going to Bangkok and
China, and is now planning a trip to India.
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