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Shame of a Nation
View From the Hot Seats
The Man Who Knows Too Much
The Culprit is Cancer

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Fall 1998
The Culprit is Cancer
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Then there was this: Though chemotherapy for breast cancer often has numerous hideous side effects, Herceptin has relatively few and comparatively mild ones. "We're fairly certain there are going to be better ways to use this drug," Slamon told the attentive crowd. An FDA ruling on Herceptin is expected by the end of the year.

Slamon only hinted at it, but the larger significance of his work with Herceptin escaped no one. Never before had anyone achieved success attacking a genetic alteration in cancer. The tenacious UCLA scientist had achieved precisely that. He had pioneered a new frontier in treating cancer.

Since his appearance at the ASCO conference, interest in Herceptin has exploded and Slamon has been inundated with calls from all over. "Most troubling," he says, "are the patients who want to know, 'When can I get it? Why can't I have it right now?' This thing is moving as fast as it possibly can. But that's hard to explain to women who have metastatic breast cancer or are dying."

Once Herceptin receives FDA approval, Slamon expects it will be used to treat women even earlier in their disease than the patients in the UCLA trials. "There is absolutely no reason to think it will work any differently," he says confidently. "The biology should be the same in early breast cancer as in late breast cancer."

There remain the women in the study for whom the drug did not work. The Big Question is: Why not? "What's going on with those women?" Slamon asks rhetorically. "Are there other alterations occurring alongside HER-2 that play a role? Are other alterations necessary to see the response? These questions are unanswered, but we're pursuing them very actively."

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