I wanted to pass along this alert from Breast Cancer Action about Herceptin. I know we all really want to believe that this is a miracle drug, but as this alert makes clear, there are still so many unanswered questions, perhaps the biggest being why are drug companies allowed to hype their products with so little evidence.
Also, The American Cancer Society has just published its bi-annual report on breast cancer, http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Death_Rates_Dropping.asp. While the report says that death rates are falling, it is not at all clear whether this adjusts for if they are simply starting to count earlier due to early detection. Notably, it does say that the incidence continues to rise. Of course no mention is made of environmental factors, rather that the data suggests that the increase is due to women continuing to have less children at a later age. As usual, it seems to be all our fault 
.
Below is the alert from BCA.
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“Take Action: Tell the NCI to Give us Herceptin Facts, not Hype
Tell the NCI to Give us Herceptin Facts, not Hype
Herceptin is a targeted therapy for breast cancer that holds significant promise for some breast cancer patients. While currently approved only for treatment of metastatic disease, recent reports about trials of Herceptin in the adjuvant setting (to reduce the risk of recurrence in women who have been diagnosed with breast cancer, have completed initial treatment, and are currently free of breast cancer) indicate that Herceptin may be even more beneficial if given earlier.
But the recent reports about Herceptin have far overstated what we currently know about the drug. The studies in the adjuvant setting have been relatively short (a maximum of 2 1/2 years of data) and yet some researchers are calling the drug a “cure.” An Associated Press article on October 19 reported: “Several experts used words like ‘revolutionary,’ ’stunning’ and ‘jaw-dropping’ to describe the findings.” The article also quotes a representative of the National Cancer Institute: “In 1991, I didn’t know that we would cure breast cancer, and in 2005, I’m convinced we have,’ exulted Dr. Jo Anne Zujewski, head of breast cancer therapeutics at the government’s National Cancer Institute.”
Using the ‘cure’ word in this context is outrageous, and is inaccurate as a way of describing these short-term trial results. Even the studies’ authors admit that it’s unknown how long Herceptin needs to be taken. At a price tag of $48,000 per year, that question becomes critically important, as does the issue of who will have access to the drug. After 2 1/2 years, we can’t possibly know all of the side effects (short and long term) in addition to the serious ones we already know, such as cardiotoxicity. As seen with drugs like tamoxifen, the entire range of side effects can take over a decade to become widely known. To read BCA’s statement to the press concerning these issues, visit our press release on the topic.
Please join Breast Cancer Action in asking the NCI to widely distribute accurate information on Herceptin. Below is sample text for contacting Dr. Zujewski of the NCI. Please e-mail a copy to Pauli Ojea so that we’ll know how many members take action. We deserve valid information from the NCI, not hype.
Dear Dr. Zujewski,
I read, as have millions of other people who are following the breast cancer news, the following statement from you regarding the NEJM publication of the data from the adjuvant Herceptin trials: “In 1991, I didn’t know that we would cure breast cancer, and in 2005, I’m convinced we have,” exulted Dr. Jo Anne Zujewski.
I believe this hype — about a drug for which we have very little information on side effects and which we know fails some patients for which it seems appropriate — has created a great deal of harm and confusion for breast cancer patients and for women concerned about the disease.
I urge you, in the strongest possible terms, to issue and distribute to the broadest possible audience a new statement, making clear that:
1) Herceptin, when it works, works only for a subset of breast cancer patients (and not even for everyone in that subset),
2) That we so far have only 2.5 years of data in the adjuvant setting, so, at this time, we can make absolutely no statement about cure for those for whom the drug does prove effective, and
3) We do not have long term side effect data, and so cannot say with any certainty at this time that the benefits in the adjuvant setting outweigh the risks.
I look forward to hearing about how you plan to address the many problems your statement has created. People need responsibly vetted information, not more hype, especially from the nation’s leading cancer agency.
Sincerely,
NAME
CC: Dr. Von Eschenbach
NCI Liaison Office”
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