For years, anticancer drugs such as doxorubicin (Adriamycin®) and paclitaxel (Taxol®) have been commonly used to treat breast cancer. Today that arsenal has expanded to include new agents that inhibit cancer growth by zeroing in on specific molecular targets. And that arsenal only appears to be growing. "New research is helping us understand how different cancers behave, enabling us to choose the most appropriate therapies based on specific molecular characteristics of a patient's tumor," explains Yelena Novik, MD, Assistant Professor of Medicine (Oncology).

The targeted agent trastuzumab (Herceptin®) was approved in 1998 for treating breast cancer. It was designed for women with advanced breast cancer that overexpresses the HER2/neu protein, which accounts for about a quarter of breast cancer cases. Two years ago, research showed that trastuzumab reduces the risk of breast cancer recurrence by half in women with early-stage breast cancer as well.

Last March, the US Food and Drug Administration approved lapatinib (Tykerb®), an oral medication for women whose breast cancer continues to grow despite treatment with trastuzumab. The NYU Cancer Institute participated in clinical trials assessing lapatinib's effectiveness. Current research suggests that lapatinib may also be useful for treating breast cancers that have spread to the brain.

Today, clinical trials continue to be conducted to assess the effectiveness of different schedules of drug dosing and new drug combinations for breast cancer —including teaming up conventional chemotherapy drugs with novel targeted agents as well as hormonal therapies (such as anastrozole) in women with metastatic disease. The drug bevacizumab (Avastin®), which is approved for treating advanced colorectal cancer and non-small cell lung cancer, has also demonstrated promise for slowing the growth of advanced breast cancer when given with conventional chemotherapy, and continues to be evaluated in clinical trials.

Another significant advance has been the development of Oncotype DX, a test that analyzes the expression pattern of 21 genes in estrogen-receptor-positive breast tumors that have not spread to the lymph nodes. The test computes a recurrence "score" that predicts which women will benefit most from treatment with chemotherapy in addition to hormonal therapy, and which could be safely spared chemotherapy. Oncotype DX forms the basis for TAILORx (Trial Assigning Individualized Options for Treatment), a national multicenter study examining whether genes frequently associated with the risk of recurrence in women with early-stage breast cancer can be used to give patients the most effective treatment with the fewest side effects. The NYUCI is participating in this study.

"The fruits of basic scientific research have reached the clinic," says Dr. Novik. "This is a very exciting time for those of us seeking new treatments for breast cancer."

For information about clinical trials evaluating new breast cancer treatments, contact the NYUCI Clinical Trials Office at 212-263-6485.

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