Newest Treatments for Metastatic Breast Cancer

 In Cancer Treatment

Cancer treatments have made great strides in the last several decades, and outlooks for patients are met with more confidence than ever. Anxiety over the unknown has been replaced with practical planning, poise and patience. Through physicians and cancer research institutions’ exceptional and hard work, even the most invasive cancer forms are being fought more efficiently and with greater success rates. Our understanding of the mechanisms behind breast cancer progression, in particular, continues to broaden and inspire hope for the millions of patients suffering from this aggressive disease. Despite the inhibiting effects of COVID felt worldwide, researchers have been diligently exploring and innovating to increase survival rates and improve quality of life for those with metastatic breast cancer. There is a long road ahead before a definitive “cure” is found, but there are many exciting technologies and methods to combat breast cancer in development for 2021.

Radiation therapies for breast cancer

Radiation therapy is one of the most common approaches to breast cancer treatment and can be utilized at any cancer development stage. A powerfully effective technique, radiation therapy is accomplished through X-rays and other high-energy particles bombarding cancer cells to kill them. It is often used after lumpectomies, where just the tumor is removed from the breast, and before mastectomies, the removal of the entire breast. Doing so helps prevent recurring growth leading to metastatic breast cancer.

New advances have been made in the application of radiation therapy within the entirety of the treatment process. Traditionally, after a lumpectomy, the entire breast’s radiation is used to destroy the remaining cancer cells, which often requires many trips to the hospital over several weeks and holds a risk of exposing healthy tissue to excess radiation levels.

Hypofractionated radiation therapy

One area of research that is showing encouraging signs is in radiation therapy. Routine radiation treatments create obstacles for patients in managing their recovery time and making it to appointments, so it emphasizes cancer research. A hypofractionated schedule accelerates the post-operation radiation treatments to five sessions in one week instead of the standard 15 sessions over three weeks. Recent research suggests that this schedule provides the same benefits as the regular schedule when used on early-stage breast cancer patients. This more convenient approach is gaining attention from doctors as it should also increase compliance, allowing patients to follow their scheduled treatments more quickly.

Intraoperative radiation therapy

An alternative approach to radiation therapy called intraoperative radiation therapy (IORT) was the subject of a recent study and offered promise in its effectiveness compared to whole-breast radiation. As opposed to postoperative radiation, IORT is administered directly to exposed breast tissue during a lumpectomy, immediately after removing the tumor. In the study, subjects were found to have similar survival and recurrence rates after IORT as patients who underwent traditional whole-breast or partial-breast radiation. However, follow-up visits and radiation treatments will be significantly reduced under IORT, saving patients time and energy in their recovery. Studies are ongoing but you can speak with an oncologist to see if this option is available in your treatment.



Proton therapy as a breast cancer treatment

An overarching concern of radiation therapy is the accuracy of its effects. The more accurate the cancerous section’s targeting, the less healthy tissue is caught in the line of fire. When healthy tissue is exposed to radiation, patients are more susceptible to side effects like fatigue, hair loss, tenderness and swelling.

The problem with X-ray radiation is that the photon beams go to the cancerous tissue and beyond, affecting any body part underneath the target area. By contrast, proton therapy delivers the particles to the affected tissue and stops them there, leaving the surrounding and underlying tissue untouched. The limited exposure leads to more minute side effects.

For those who have breast cancer, proton therapy could help solve a major problem in finding methods to reduce side effects when radiation is used alongside other treatments. In tests where subjects simultaneously received chemotherapy and radiation treatments, patients who received proton therapy were far less likely to develop serious side effects than patients undergoing traditional radiation treatments. While there were considerable limitations to the study, researchers expressed optimism about the indications of proton therapy’s efficacy and clinical trials are ongoing to discover more benefits.

Targeted therapy advancements for breast cancer

A central component of the battle against breast cancer, targeted therapy uses drugs or other agents to attack cancer cells while minimizing harm to healthy cells specifically. New drugs are continually being developed. Researchers see encouraging signs in their ability to aid with advanced breast cancer cases and metastatic breast cancer, where cancer cells have spread to nearby tissue.

HER2-Positive treatments

HER2-positive breast cancer is fast-developing cancer defined by an overabundance of the HER2 protein, which accelerates cancer cells’ growth and spread. Targeted therapy treatments have been used for the past two decades to treat this form of the disease and drugs that have gone to trial in the last several months have shown great deals of promise.

Variants of commonly used monoclonal antibodies and antibody-drug conjugates (ADCs) are produced to both target cancer cells more accurately and destroy them more efficiently. Trastuzumab deruxtecan, an ADC, is based on a prevalent monoclonal antibody, trastuzumab. Monoclonal antibodies are designed to bind specifically to cancer cells, allowing a carried cancer-killing agent to take effect where it is needed. The new drug combines the monoclonal antibody’s cancer cell-targeting capabilities with a potent chemotherapy drug to destroy the cells.

Tucatinib, an inhibitor drug, targets the HER2 protein and prevents it from encouraging further cancer growth. While HER2 inhibitors already exist on the market, tucatinib will offer another treatment line that may succeed where other drugs fail. In clinical trials, tucatinib showed superior survival rates compared to similar chemotherapy drugs, with tumor shrinkage and remission rates being higher.

Triple-Negative Breast Cancer

Triple-negative breast cancer is a particularly aggressive form that spreads quickly and is exceptionally difficult to treat. Due to a lack of receptors and HER2 protein, targeted therapy and hormone therapy are generally unable to latch onto triple-negative breast cancer cells. Now, an innovative targeted therapy drug that has recently passed FDA approval may present a new opportunity for patients to pursue effective treatment.

Recently approved by the FDA, Trodelvy (sacituzumab govitecan-hziy) is an ADC used for treating patients with metastatic triple-negative breast cancer. This advanced spread of the disease responds poorly to most treatments and several different therapies are often applied in concert to slow its growth. Trodelvy was administered routinely to 108 patients in a clinical trial, with one-third showing positive response and tumor shrinkage.



PARP Inhibitors in breast cancer research

PARP inhibitors appear under a variety of names and are used to treat several different forms of cancer. Recent breast cancer research has indicated the usefulness of PARP inhibitors in aiding the effectiveness of associated chemotherapy treatments. In advanced breast cancer cases, stronger cancer cells can often successfully combat chemotherapy drugs. PARP inhibitors may be able to reduce the ability of cancer cells to develop this resistance. Two new drugs, talazoparib (Talzenna) and olaparib (Lynparza), recently passed FDA approval to treat HER2-negative breast cancer in a small set of patients with BRCA1 or BRCA2 gene mutations. Current research is being performed into PARP inhibitors for treating additional instances of metastatic breast cancer and triple-negative breast cancer, as well as reducing recurrence in early-stage patients.

Breast cancer innovations in immunotherapy

As opposed to invasive measures commonly used to treat breast cancer, such as surgery, immunotherapy conditions the body to use its immune system to fight off cancer cells; immunotherapy treatments can include vaccines, inhibitors, antibodies and gene therapy. Targeting and killing cancer cells through immunotherapy is uniquely compelling and preventative as a treatment for metastatic breast cancer. The immune system can more accurately target cancer cells and bolster its responsiveness to new cancer cells as they emerge. 

Immunotherapy has traditionally been applied to treat lung, bladder and skin cancers among others but breast cancer has presented ongoing trouble for researchers. However, recent developments in a particular form of immunotherapy, checkpoint inhibitors, have shown promise for metastatic breast cancer. Checkpoint inhibitors remove natural limitations from your immune system, allowing it to use cell-killing proteins more effectively and unleashing its full potential to defeat cancer growth. There has been recent FDA approval for a handful of immunotherapy drugs. Atezolizumab (Tecentriq) and pembrolizumab (Keytruda) have been approved as treatments for metastatic breast cancers. Pembrolizumab is also currently being studied for uses in metastatic triple-negative breast cancer.



Breast cancer treatment in Raleigh

The future holds great promise for metastatic breast cancer survival rates and the improvement of life after cancer. Our growing body of knowledge and technology advancements are rapidly accelerating the success of treatments and streamlining recovery. The most critical factor in finding the best treatment option available for breast cancer patients is a close relationship with your oncologist. Breast cancer cases are unique in nature and understanding, requiring precision in the treatment regimen. Consistent, open communication and partnership with your physician allow for a comprehensive understanding of your condition so they can offer the most efficient and manageable path to recovery.

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