OTTUMWA — The McCreery Cancer Center at Ottumwa Regional is participating in an exciting study.

Two targeted medications designed to treat an aggressive form of breast cancer are being tested in a new study involving 8,000 participants in 50 countries across six continents — a clinical trial that investigators hope will provide a new model for global cancer research. This trial, dubbed ALTTO (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization study), will be one of the first global initiatives in which two large, academic breast cancer research networks involving different parts of the world have jointly developed a study in which all care and data collection are standardized, regardless of where patients are treated. The networks are The Breast Cancer Intergroup of North America (TBCI), based in the United States, and the Breast International Group (BIG) in Brussels, Belgium.

“There have been major improvements in the management of patients with early breast cancer in the last few years, so this new study builds on this knowledge and sets an example of the new era: good science, good worldwide collaboration,” said Edith Perez, M.D., an oncologist in the North Central Cancer Treatment Group at Mayo Clinic in Jacksonville, Fla., who will lead the study for TBCI. “It may be that using two treatments that work in different ways against HER2-positive breast cancer offers a complementary strategy that is more powerful than either drug alone.”

ALTTO is designed to answer the most pressing questions regarding use of two widely used cancer agents: whether one agent is more effective, which agent is safer for patients, and what benefit will be derived by taking the drugs separately, in tandem order, or together?

The two agents tested in ALTTO are drugs designed to treat HER2-positive tumors, which is a particularly aggressive form of cancer that affects

approximately 20 percent to 25 percent of breast cancer patients. HER2-postivie breast cancer is caused by an excess of HER2 genes or by over

production of its protein. Both agents, trastuzumab (Herceptin) and lapatinib (Tykerb), have already been approved by the U.S. Food and Drug

Administration for use for treatment of HER2-positive breast cancer. ALTTO will provide the first head to head comparison of trastuzumab and lapatinib in the earliest, most treatable stages of cancer. It will also be one of the first large scale studies to evaluate lapatinib’s effectiveness in treating early breast cancer.

To date, more than 300 centers around the world have enrolled patients into ALTTO. Full enrollment is expected to involve about 500 centers in the United States and more than 800 centers in Europe and the rest of the world.