Breakthrough Metastatic Breast Cancer Treatment Hits Snag
CHICAGO A stunning breakthrough in treating metastatic breast cancer caught the attention of patients around the world. Early findings showed a new compound killed 95 to 100 percent of cancer cells in animals. But the promising new drug may have hit a snag on its road to human trials.
It was hard to imagine that we had a drug that would take cancers and cause them to just disappear in a matter of days, said biochemistry professor David Shapiro. That was his reaction when imaging came back showing that the drug ErSO successfully targeted and killed metastatic breast cancer tumors in mice.
All the tumors have been eradicated, they’ve been destroyed and they’re no longer detectable, he told us back in August.
The compound developed by a team at the University of Illinois Urbana-Champaign worked in just days, without reoccurrence of cancerous tumors or any noticeable side-effects.
We have been making these kinds of drugs for over a decade and none of them ever did anything remotely like that, said Shapiro.
It was so promising that pharmaceutical giant Bayer bought the exclusive licensing rights to develop ErSO as a cancer therapy in partnership with Arizona-based Systems Oncology a year before the Illinois study was even published. It was a deal originally worth up to $370 million.
For metastatic breast cancer patients around the world, it was astounding.
Hundreds of people like Mullins formed an advocacy group on Facebook to follow the ErSO progress.
Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open or painful wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent or treat bone fractures
- When a cancer is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms anywhere in the body
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand the goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
Immunotherapy To Treat Metastatic Breast Cancer
Cancer immunotherapy medicines work by helping your immune system work harder or more efficiently to fight cancer cells.
Your immune system is made up of a number of organs, tissues, and cells that work together to protect you from foreign invaders that can cause disease. When a disease- or infection-causing agent, such as a bacterium, virus, or fungus, gets into your body, your immune system reacts and works to kill the invaders. This self-defense system works to keep you from getting sick.
Immunotherapy uses substances either made naturally by your body or man-made in a lab to boost the immune system to:
Learn more about immunotherapies used to treat metastatic breast cancer.
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New Drug For Early Breast Cancer: First Advance In 20 Years
October 13, 2021 — The FDA on Wednesday approved a new drug for one type of breast cancer, a development one scientist says is the first real advancement in 20 years.
The drug, called abemaciclib â brand name Verzenio â is now approved for patients with the HR+, HER2-early breast cancer, which makes up 70% of all breast cancers.
The drug was already approved for advanced, or metastatic, breast cancer.
“This is the first time in more than 20 years that we have seen an advance in the adjuvant treatment of this form of breast cancer,” lead investigator Stephen Johnston, MD, from the Royal Marsden Hospital NHS Foundation Trust, London said at a recent meeting of the European Society of Medical Oncology..
The new drug will âchange practice,â said Giuseppe Curigliano, MD, head of the Division of Early Drug Development at the European Institute of Oncology, in Milan, Italy.
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Palliative And Supportive Care
Palliative and supportive care can be helpful at any stage of your illness to:
- prevent and relieve symptoms, such as pain or fatigue
- help you deal with any other physical, emotional, social and spiritual effects of secondary breast cancer
People often think of palliative care as being associated with end-of-life treatment, so are worried when its mentioned as part of their care.
However, many people benefit from having advice from a palliative care team much sooner, alongside their medical treatment.
Palliative care usually involves a team of healthcare professionals such as:
- specialist nurses
- physiotherapists
- occupational therapists
You can be referred by your specialist team, GP or specialist nurse depending on your situation.
Your needs and those of your family will be assessed by the palliative care doctor or nurse, who may see you at the hospital, hospice or in your own home.
If palliative care input is no longer needed, you can be discharged but be seen again when required. It can continue up to and including end-of-life care.
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Will Ever Be A Cure For Triple
Triple-negative breast cancer is curable when a doctor diagnoses it during the first three stages , said Dr. Jacoub. He treats stages 13 with everything he can in order to remove and destroy the cancer.
However, the ability to cure triple-negative breast cancer is hindered by recurrence or metastasis past the lymph nodes. Triple-negative breast cancer is the most likely form of breast cancer to return.
The outlook for people with localized triple-negative breast cancer over a 5-year period is good. Around 91% of people will survive to the 5-year mark.
If the cancer spreads to local tissue or lymph nodes, however, the 5-year survival rate drops to 65%. If it spreads to other organs or tissue, the rate falls to 12%.
These figures are based on data for people who received treatment in the past. Newer methods have changed the outlook, which will continue to shift as different treatments become available.
Anecdotally, Dr. Nan has a segment of patients who have responded to immunotherapy treatment for longer than 5 years.
Maybe if follows these long enough, some may still be alive after more than 10 or 15 years, then we can say cured, he said. With developed or newer types of immunotherapy, may be able to cure stage 4 cancer in the future.
Dr. Jacoub agreed that the outlook is changing with newer treatments. He also noted that although some people have a reduced quality of life while undergoing treatment, others can maintain a good quality of life.
Emerging Therapies Show Promise In Treating Metastatic Breast Cancer
An expert discusses the potential that several novel therapies hold in treating metastatic breast cancer, including PARP inhibitors, immunotherapy and antibody drug conjugates. Each therapy type has an FDA-approved option to potentially provide patients with better outcomes and quality of life.
Although metastatic breast cancer remains incurable, several novel therapies have been approved by the Food and Drug Administration and have been shown to improve outcomes, including immunotherapy, antibody drug conjugates and poly -ribose polymerase inhibitors.
In a presentation at CURE®s Educated Patient® Breast Cancer Summit, Dr. Neelima Vidula, breast oncologist at Massachusetts General Hospital and Harvard Medical School, detailed the available drugs for each of these novel therapies, how they can benefit patients with metastatic breast cancer and what side effects to be aware of. CURE® also spoke with Vidula to learn more about the development and FDA approval of these treatments over the past several years and what implications they may have for patients.
CURE®: What are some of the major takeaways from your presentation?
PARP inhibitors are really exciting because these are oral-targeted therapies that target the DNA damage repair pathway. They’re exciting because they’re oral drugs that can be taken at home and tend to have less side effects than standard chemotherapy.
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Treatment For Secondary Breast Cancer
If your breast cancer has spread to another part of your body, you may be offered one or more different treatments.
Treatments commonly used in secondary breast cancer include:
- hormone therapy if your cancer is hormone receptor positive
- bone-strengthening therapy if the cancer is in your bones
Radiotherapy may be used to control the cancer or relieve symptoms if the cancer has spread to the bones or brain.
Surgery is not commonly used to treat secondary breast cancer, but may occasionally be considered.
You can read more information about how these treatments are used in our pages on secondary breast cancer in the:
The Katherine Trial Found That Patients With Her2
Traditionally, trastuzumab-based regimens were not indicated for patients with HER2-low disease. the standard of care, which was anti-hormonal therapy or chemotherapy if they had either hormone receptorpositive or triple-negative disease.
In HER2-low disease, trastuzumab deruxtecan as a treatment option is certainly going to change how we consider those patients, because now we are essentially creating a different category . Having a drug that is effective in the HER2-low population also reduces the number of patients we consider to have triple-negative disease. HER2-low, ER-negative disease. It is almost like a fourth category is being created. HER2-low breast cancer , where we can use trastuzumab or other ADCs, such as and even trastuzumab emtansine, potentially.
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Providing Palliative Care Services To Women Living With Secondary Breast Cancer And Their Carers Can Improve Carers Sense Of Wellbeing
Researchers in the U.S. conducted a study of 207 people living with advanced cancer and 122 of their caregivers. The researchers explored whether a telephone-based palliative care program for people diagnosed with advanced cancers and their carers may have a positive impact on caregivers quality of life. The palliative care program aimed to help people with advanced cancers manage their symptoms, as well as improve mood and quality of life for those with cancer and their caregivers.
Participants and their caregivers were randomly allocated to a group receiving the phone-based program immediately or a group receiving the program 12 weeks after the initial group received the program.
The study found that caregivers who were part of the group immediately receiving the palliative care program had lower rates of depression and a better quality of life. The researchers conclude that providing palliative care as early as possible for people living with advanced cancers and their caregivers can have benefits for caregivers wellbeing and quality of life.
While the research was not specific to women living with secondary breast cancer, it may have relevance for women diagnosed with secondary breast cancer and their loved ones.
- For more information on this study, please visit the Abstracts Library for the 2014 ASCO Annual Meeting.
Should You Consider A Clinical Trial
The prognosis for people with metastatic breast cancer continues to improve, thanks in large part to new treatments developed in clinical trials. Still, fewer than 1 in 20 people with cancer participate in a clinical trial.
Findings from a 2014 landmark report from the Metastatic Breast Cancer Alliance found that most people with metastatic breast cancer want to try investigational treatments that might add years to their lives.
Clinical trials provide other benefits like:
-
more frequent health screenings, which may lead to better overall health
-
potential for fewer treatment side effects
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Nih Study Advances Personalized Immunotherapy For Metastatic Breast Cancer
An experimental form of immunotherapy that uses an individuals own tumor-fighting immune cells could potentially be used to treat people with metastatic breast cancer, according to results from an ongoing clinical trial led by researchers at the National Cancer Institutes Center for Cancer Research, part of the National Institutes of Health. Many people with metastatic breast cancer can mount an immune reaction against their tumors, the study found, a prerequisite for this type of immunotherapy, which relies on what are called tumor-infiltrating lymphocytes .
In a clinical trial of 42 women with metastatic breast cancer, 28 generated an immune reaction against their cancer. The approach was used to treat six women, half of whom experienced measurable tumor shrinkage. Results from the trial appeared Feb. 1, 2022, in the Journal of Clinical Oncology.
Its popular dogma that hormone receptorpositive breast cancers are not capable of provoking an immune response and are not susceptible to immunotherapy, said study leader Steven A. Rosenberg, M.D., Ph.D., chief of the Surgery Branch in NCIs Center for Cancer Research. The findings suggest that this form of immunotherapy can be used to treat some people with metastatic breast cancer who have exhausted all other treatment options.
The immunotherapy approach used in the trial was pioneered in the late 1980s by Dr. Rosenberg and his colleagues at NCI. It relies on TILs, T cells that are found in and around the tumor.
Clinical Trials And Research Studies
Clinical trials and research studies are common in secondary breast cancer. They aim to find new or better treatments. They may also look at using existing treatments in different ways.
Clinical trials for people with secondary breast cancer may look at:
- new drug treatments
- new doses or regimes of drugs
- new ways of measuring response to treatment
- new types of palliative and supportive care to control symptoms
- patient attitudes towards treatments
- how treatment affects quality of life
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How You Can Help
Ask your doctor if there are clinical trials that would be a good fit for you. They test new treatments before theyâre available to the public. Your doctor, and the study leaders, can let you know whatâs being tested, what your commitment involves, and what the risks and benefits are.
You may also want to look into the Metastatic Breast Cancer Project , led by the Broad Institute and the Dana-Farber Cancer Institute. It describes itself as âa nationwide movement of patients, doctors, and scientistsâ with the common goal of âspeed the development of future therapies.â
To get involved, fill out an online consent form allowing the project to contact your doctors for your medical records and a portion of your stored tumor samples. This information will be added to a national database and shared with metastatic breast cancer researchers everywhere.
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Learning More About How The Cancer Spreads
A new study challenges the long-held belief that the disease spreads when a single cell âescapesâ from the tumor and travels through the bloodstream to other organs.
Researchers at Fred Hutchinson Cancer Research Center and Johns Hopkins Medical Institute discovered that breast cancer cells actually travel in clusters throughout all stages of this spreading, or “metastasis.” Having a better understanding of how cancer behaves will help researchers come up with more targeted ways to stop it.
A few months earlier, a study published in Nature also turned the tables on our understanding of how breast cancer cells move through the body. Experts had thought that these cells have to go through a shape-changing process called EMT before they can spread. But the new study shows that breast tumor cells that went through EMT werenât involved in metastasis.
âThere is a substantial effort underway to develop drugs aimed at reversing the EMT process in order to halt metastasis, but our findings suggest that this approach may not work,â researcher Vivek Mittal, PhD, said in a statement.
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Circulating Tumor Cells And Circulating Tumor Dna
Circulating tumor cell levels can help predict survival for people with metastatic breast cancer .
The more circulating tumor cells in the blood, the more advanced the metastatic breast cancer tends to be.
Having more circulating tumor cells may also predict a lack of response to treatment.
Circulating tumor DNA is also under study for use in monitoring metastatic breast cancer and predicting treatment response .
Circulating tumor cell and circulating tumor DNA tests are not used today to guide treatment. This is because they havenât been shown to offer benefit .
However, these methods are under study.
Systemic Treatments For Stage Iv Breast Cancer
Treatment often continues until the cancer starts growing again or until side effects become unacceptable. If this happens, other drugs might be tried. The types of drugs used for stage IV breast cancer depend on the hormone receptor status, the HER2 status of the cancer, and sometimes gene mutations that might be found.
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New Therapies May Offer Hope For Patients With Metastatic Breast Cancer
With more than two million new cases diagnosed in 2018, breast cancer is the most common cancer in women worldwide. The disease represents about 25% of all cancers in women. Incidence rates vary widely across the world, from 27 per 100,000 in Middle Africa and Eastern Asia to 85 per 100,000 in Northern America. Breast cancer is also the fifth most common cause of death from cancer in women globally, with an estimated 522,000 deaths annually
An estimated 90% of all breast cancer is diagnosed at an early stage. And approximately 70% of all breast cancers are HR+, HER2-, the most common subtype of the disease. Even within this subtype, HR+, HER2- breast cancer is a complex disease, and many factors, including cancer which spread to the lymph nodes and the biology of the tumor, can impact the risk of recurrence. Recent data shows that about 30% of people diagnosed with HR+, HER2- early breast cancer are at risk of their cancer returning, potentially leading to incurable metastatic disease.
Although an advanced disease, most women with metastatic or stage IV breast cancer are treated with systemic therapy. This treatment may include hormone therapy, chemotherapy, targeted therapy, or a combination of these options.
No an end-stage cancer While some people may refer to metastatic breast cancer as end-stage cancer, the disease is NOT hopeless and many people continue to live long, productive lives with breast cancer in this stage.