"Adding the monoclonal antibody drug trastuzumabalready used to treat certain breast cancersto the chemotherapy regimen of women with a rare form of uterine cancer https_healthgynecological_cancers_uterinesarcoma lengthens the amount of time their tumors are kept from growing according to Johns Hopkins Medicine researchers conducting a small phase II trial of the regimen testing its safety and value. The results of the trial published online ahead of print on March  in the Journal of Clinical Oncology show that the drug extended the length of time to tumor progression by four to eight months in the sevenyear trial. The researchers say this may lead to new national guidelines for treating this cancer subtype known as uterine serous carcinoma. Uterine serous carcinoma makes up less than  percent of all cancers of the endometrium or lining of the womb diagnosed in the United States each year but it accounts for more than a third of the  endometrial cancer deaths annually. The aggressive carcinomas often dont cause symptoms until theyve begun to spread throughout the body. As a result the average time that standard chemotherapy and surgical treatments can keep the tumor from growing or spreadingknown as progressionfree survivalis only about eight months. The fact that these tumors grow rapidly but also have a propensity to spread to lymph nodes and other organs very early is a double whammy for women says Amanda Fader M.D. https associate professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine and first author of the new study. Fader and her colleagues knew that about  percent of all uterine serous carcinomas test positive for HERneu a receptor protein that is also overexpressed in about  percent of all breast cancers. Trastuzumab binds to and blocks HERneu keeping it from driving tumor growth and has been shown to be effective in socalled HER positive breast cancers. From August  through March  Fader Alessandro Santin M.D. professor of gynecology and obstetrics at Yale University and collaborators at  other cancer treatment centers in the U.S. randomly assigned  women with uterine serous carcinoma being seen at the participating institutions to receive either the standard chemotherapeutic regimena combination of the drugs carboplatin and paclitaxelor those drugs plus trastuzumab. Some  of the patients had stage  or  uterine serous carcinomaknown as advanced diseaseand  had recurrent uterine serous carcinoma. All tested positive for the HERneu receptor. Among all patients the  controls receiving only the standard carboplatin and paclitaxel combination had an average progressionfree survival time of eight months and the  who received trastuzumab in addition had an average progressionfree survival time of . months. However the difference was even more profound in the  patients with advanced disease whose progressionfree survival time went from an average of . months to . months with the addition of trastuzumab. Even an improvement of a few months may be quite meaningful for women with these cancers says Fader who is also affiliated with the Sidney Kimmel Comprehensive Cancer Center https_cancer_centerindex.html at Johns Hopkins. Among patients with recurrent disease progressionfree survival time increased from an average of six months to . months. The difference Fader says may be that these patients have been heavily treated in the past are more likely to have overall poorer health and are more likely to have mutated or heterogeneous tumors or tumors with different levels of HER expression. Followup studies of the women who remain alivewho now number continue the researchers say to track the impact of trastuzumab on overall survival time even after tumor progression. But the results of the trial they add were strong enough to warrant submission to the National Comprehensive Cancer Network which guides the design of standard treatment plans around the country. Fader cautions that a larger study of the drug combination or other combinations is needed to confirm the findings and potentially extend survival even more. She notes that using trastuzumab to selectively treat uterine serous carcinoma that express HERneu is part of a broader trend at Johns Hopkins and other cancer centers to use the tools of tailored therapy or precision medicine based on the molecular and genetic makeup of tumors and patients. Other authors of the paper are Dana M. Roque of the University of Maryland Paul Celano of Greater Baltimore Medical Center William Lowery of Walter Reed Medical Center Eric Siegel of the University of Arkansas for Medical Sciences Natalia Buza Pei Hui Osama Abdelghany Stefania Bellone Masoud Azodi Babak Litkouhi Elena Ratner DanArin Silasi Peter E. Schwartz and Alessandro D. Santin of the Yale University School of Medicine Setsuko K. Chambers of the University of Arizona Angeles Alvarez Secord and Laura Havrilesky of Duke University School of Medicine David M. OMalley and Floor Backes of The Ohio State University School of Medicine Nicole Nevadunsky of Montefiore Medical Center Babak Edraki of John Muir Medical Center Dirk Pikaart of the Penrose Cancer CenterSt Francis and Karim S. ElSahwi of Meridian Health. The study trial was funded by GenentechRoche. The drug used in this research was also provided by GenentechRoche which makes one brand of trastuzumab. COI Amanda Fader has reported a consulting or advisory role for Merck which also makes HERher blocking drugs. Fader no longer holds that role."