BOX 6-5

Also known as trastuzumab, Herceptin® is a monoclonal antibody that was engineered to target a specific cancer cell protein, HER2 (also called HER2/neu or c-erbB2), and to inhibit tumor growth.

Herceptin® is the first biologic therapy ever approved for the treatment of breast cancer. Unlike previous treatment protocols (such as chemotherapy) which are toxic to all cells, healthy and malignant, biologic therapies target specific malfunctions in cancer cells and correct those cells alone.

participating sites. Finally, the investigators increased the reimbursement for participants’ health care to some of the clinics. (Other aspects of ALLHAT will be discussed below.)

Private breast cancer organizations have had a significant impact on the accrual of several critical breast cancer trials. In the mid-1990s, the National Breast Cancer Coalition was instrumental in rescuing the Herceptin® trials (Box 6-5), partly through advising the study investigators on how to redesign the study to make it more acceptable to participants, and partly through campaigning to encourage women to enroll. In contrast, breast cancer advocates were initially a deterring force in trial enrollment for the trials of high-dose chemotherapy with bone marrow transplantation (HDC/ BMT). The completion of those trials was delayed for several years because of a widespread, but mistaken belief that the HDC/BMT treatment already had been shown to be effective. When well-designed trials were eventually completed, the treatment was shown to be largely ineffective. Over time, breast cancer advocacy groups rallied to support these trials, and they are clearly an important ally in the success of clinical trials in breast cancer (Table 6-3).

The public has shown tremendous support for breast cancer research. Last year alone, tens of thousands of women ran 26-mile marathons. Thousands more walked 3-day marathons in heroic efforts to reduce the suffering of others from breast cancer. Many more added their support by donating money—millions of dollars altogether.

Major corporations also support breast cancer research. Pink ribbons are everywhere, from stamps to yogurt lids to T-shirts. The Breast Cancer Research Foundation website notes that given two equally matched products, consumers are more likely to choose the one associated with a pink ribbon.

Many of the thousands of women who participate in or donate their support for marathons might also embrace the idea of contributing in other

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