Tag: breast cancer

12 Jun 2018

Skip the Chemo?

Breast cancer treatments have made impressive strides in terms of increasing survival rates for patients; however, a huge new study reveals that chemotherapy may not be as important of a factor for some women with breast cancer as previously thought. In fact, in some categories of breast cancer, most patients who received chemotherapy may not have actually benefitted from it. In other words, these patients would have survived just as well without the addition of chemotherapy.

This new research, which was discussed at the American Society of Clinical Oncology and published in the New England Journal of Medicine, could lead to an overhaul of the decision making process, as experts rely on better research-based guidelines to decide which patients should (and which shouldn’t) have chemotherapy added to their plan of care.

Chemotherapy generally brings painful side effects for patients, although those can certainly be worth it if life is extended. In a decade-long study of more than 10,000 women with breast cancer, there was no benefit of chemotherapy for patients with the most common type of breast cancer. Specifically, this common type of breast cancer is characterized as hormone-receptor–positive, HER2-negative, axillary node–negative breast cancer with a midrange 21-gene recurrence score. Women with this most common breast cancer did not garner benefits from chemotherapy, as opposed to surgery and hormone therapy. (There were exceptions; however, for some younger women and some women older than age 50.)

What Does This All Really Mean?

Up to 70% of women with the most common type of breast cancer don’t need chemotherapy (which means these women can also skip the nausea, hair loss, and anemia that chemotherapy generally brings with it).

This new study adds to our understanding of breast cancer treatment and continues to create a clearer picture of how to personalize treatment based on each individual’s specific tumor qualities.

The take-away is this: each year in the U.S. there are now 70,000 women with breast cancer who might be able to skip chemotherapy and still have the same chance of beating this disease. Of course, it’s best for patients to discuss with their oncologists about what is the best course of treatment for their specific situation.

Source

Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. New Engl J Med June 3, 2018 DOI: 10.1056/NEJMoa1804710

30 Jan 2018

Breast Cancer Treatment Options Expanding

Targeted cancer therapies aim to best match the treatment to specific characteristics of cancer cells. Increasingly, breast cancer treatment is based on targeted therapy medications. With targeted therapy, the harm to healthy cells can be lessened and thus side effects can be less severe than from traditional chemotherapy.

Earlier this month, the FDA approved a new targeted therapy for BRCA-positive, HER2-negative metastatic breast cancer: Lynparza (olaparib). Previously, Lynparza was approved for treating some types of ovarian cancer. Lynparza is a PARP inhibitor. The PARP enzyme’s role is to fix DNA damage, but it does this fixing to both healthy and cancerous cells. By blocking this enzyme, Lynparza helps keep breast cancer cells from growing.

Just about a quarter of patients with hereditary breast cancers and up to one in every ten patients with any type of breast cancer have a BRCA mutation. Women with breast cancer can take a genetic blood test, called the BRACAnalysis CDx, which indicates whether Lynparza would be appropriate targeted cancer therapy for their breast cancer. The results with Lynparza are promising, with a reduction in disease progression or death by 42%, when compared to traditional chemotherapy.

This was not the only good news about breast cancer this month. Kisqali (ribociclib) from Novartis received FDA Breakthrough Therapy designation for initial endocrine-based treatment in premenopausal women with HR+/HER2- advanced breast cancer. Kisqali is a cyclin-dependent kinase 4/6 inhibitor (like the medication Ibrance), which means it works by blocking a certain protein needed in cell division.

The pipeline of new targeted therapies for breast cancer is important news, especially in light of the fact that premenopausal breast cancer remains the leading cause of cancer death in women 20-59 years old.

By The Numbers

12.4%  Women in the U.S. who will be diagnosed with breast cancer at some point in life

266,120  Number of new breast cancer patients estimated in 2018

3.1 million  U.S. women with a history of breast cancer

85%  Women who develop breast cancer despite no family history

Sources

FDA approves first treatment for breast cancer with a certain inherited genetic mutation. FDA News Release January 12, 2018.

Novartis Kisqali® received FDA Breakthrough Therapy designation for initial endocrine-based treatment in premenopausal women with HR+/HER2- advanced breast cancer. Press release January 3, 2018.