Herceptin, also called trastuzumab, is a cancer drug used to treat aggressive HER2-positive early-stage breast cancer. It is credited with saving many patients’ lives, but it often has some difficult side effects, including possibly permanent damage to the heart. For most people, it is prescribed for a year or longer, meaning patients must pay a great deal of money, spend lots of time in the hospital and at doctor’s appointments, and suffer from side effects during the course of their treatment. But a recent study might change all that.
The study, which was conducted in Britain and paid for by the British government, followed thousands of women with breast cancer for several years (median of over five years) to see how their treatment plans affected their treatment outcomes and cancer recurrence rates. Researchers found that for patients with stage I, II, or III breast cancer, Herceptin is just as effective when only taken over the course of six months, as opposed to a year or more.
A year-long course of Herceptin costs about $76,700, so patients who elect to undergo a shorter course of Herceptin stand to save a substantial chunk of change. They’ll also likely experience less severe side effects and spend less time making trips to hospitals and other healthcare facilities for treatment.
Research like this, which aims to discover when treatment should be stopped to provide the patient with the maximum benefit and the best outcome in terms of cost and side effects, is rarer than it should be. Pharmaceutical companies are not eager to fund or conduct this type of research for obvious reasons; if they discover a drug shouldn’t be taken for as long as was previously assumed, it’s money out of their pockets.
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“When drug companies do research, they’re interested in gaining knowledge such that they can make money for their shareholders,” says Dr. Otis W. Brawley, chief medical and scientific officer of the American Cancer Society. “There is a difference. You will not see drug companies doing this kind of study. They don’t mind that somebody else did it, but they will not get caught doing a study that decreases their bottom line.”
But cancer drugs and other strong medications can be toxic, so taking a medication for a longer period of time than necessary may be more than just unwarranted—it could be unsafe as well.
This issue likely extends to other cancer drugs and medications for other diseases. It is important, for the well-being of so many patients who take pharmaceutical drugs, that the efficacy of those drugs be thoroughly studied. Taking a drug for longer than needed often has an immense physical, psychological, and financial burden on patients, and it could be causing more harm than we’re even aware of yet.
Luckily, this is not the first study of its kind to find. Other research has found that stopping treatment earlier can improve patient experiences without sacrificing efficacy. A 2017 study found that many colon cancer patients would receive just as much benefit from three months of chemotherapy treatment as from six. And in 2016, research done on gene activity in breast tumors showed that some women with early-stage breast cancer could safely skip pre-surgery chemotherapy treatments. There is also an increasing understanding among doctors and researchers that some cancer cases can be simply monitored rather than being immediately treated.
The Herceptin study provides hope for better financial, emotional, and physical health for many women and men who currently have cancer or will have cancer in the future. However, many experts are reserving judgment regarding the results of the study until it has been published and peer-reviewed. The 12-month course is still the only regimen of Herceptin approved for early-stage breast cancer by the Food and Drug Administration.
A spokesperson from Genentech, the maker of Herceptin, said in a statement that her company had not found the drug to be as effective when taken for a shorter period of time.Whizzco