M.D. Anderson Cancer Center, Houston, Texas

My name is Francisco Esteva. I'm a medical oncologist at M.D. Anderson Cancer Center and my research is focused on breast cancer.

Breast Cancer is not one disease but many diseases and we are beginning to understand at the molecular level how they are different from patient to patient. Breast cancer is a genetic disease and different types of breast cancer have different genes or proteins that make their prognoses and types of treatment different from different patient populations.

My research is focused on a subtype of breast cancer called HER2-positive breast cancer. HER2 is an oncogene that is amplified or over-expressed in about 25 percent of patients with breast cancer. These patients have a poorer prognosis compared with patients whose tumors do not over-express this gene or this protein called HER2, and luckily we have new treatments directed this specific type of breast cancer.

The first treatment was a monoclonal antibody called trastuzumab or Herceptin that is directed against this particular protein called HER2. A new treatment that became available recently is called lapatinib or Tykerb and that is a small molecule also targeting the HER2 receptor. Trastuzumab, the monoclonal antibody, has been an excellent addition to our treatment armamentarium. It has prolonged survival in patients with advanced breast cancer and also patients with early-stage breast cancer.

However, many patients develop progressive disease while receiving this treatment and the mechanisms of resistance to these particular therapies were not well understood. Our laboratory over the last few years has studied this type of problem and we discovered several mechanisms of resistance to these particular targeted biologic therapies. And now we are testing ways to overcome this resistance in breast cancer patients at M.D. Anderson Cancer Center.

One of the treatments we have is called RAD1, which is an mTOR inhibitor, a different protein expressed in these cancer cells. And we are combining this therapy with trastuzumab in patients who failed the trastuzumab monoclonal antibody therapy. We're also doing clinical trials trying to move these therapies into the frontline setting. For example, one trial we are combining trastuzumab and lapatinib, the two new treatments for breast cancer, for the HER2-positive breast cancer and we are doing a frontline therapy trial which hopefully will be launched in many other institutions soon to try to achieve better response rates, improve survival and hopefully achieve a cure of this disease.

Click here for more info on breast cancer treatment and research at the M.D. Anderson Cancer Center, Texas.

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