I recently saw a 34-year-old woman diagnosed with breast cancer. Not too long ago, I would have asked myself, “What is the stage of the cancer?” Now I ask, “What type of cancer is this?”
This is an exciting time in cancer treatment, the era of personalized cancer therapy and targeted treatments. When we say “targeted,” we’re referring to the proteins on or in the cancer cell that may cause the cancer to grow. Targeted treatments are the medicines that attack those proteins to kill the cancer cells.
Personalized therapy is not new for breast cancer — tamoxifen is one of the oldest medicines to treat women with estrogen receptor-positive cancer. It has received significant press lately with the Obama administration’s pledge of $215 million to a new Precision Medicine Initiative. This initiative will advance research into treatments tailored to patients according to their genetics and health history.
Here are some of the most recent developments in breast cancer therapy.
- One in five breast cancers is typically HER2-positive, which means a gene is present that makes breast cancer cells grow and divide in an abnormal way. An array of drugs like Herceptin® have been approved to treat this type of breast cancer. These drugs are getting unprecedented cancer responses and survival.
- For patients who carry the BRCA gene, a new group of medicines is being studied. The BRCA genetic abnormality occurs in breast cancer, as well as in ovarian, prostate and other cancers. A group of drugs called PARP inhibitors fix the damaged DNA cells. One of these medicines, Lynparza®, is already approved for ovarian cancers.
- For cancers that grow because of signals they’re getting from hormones, the FDA recently approved Ibrance®. It works with the drug letrozole against breast cancer cells that are estrogen receptor-positive or progesterone receptor-positive.
- Immunotherapy, where a person’s own immune system is used to attack the cancer, might be the next big thing. Drugs like Opdivo® and Keytruda® have achieved remarkable success in treating lung cancers and melanoma. They’re now being studied in triple-negative breast cancers, which are cancers that are neither hormone or genetic types.
Although we have made significant strides in better understanding the behavior of breast cancer and developing more effective drugs, there is no substitute for early diagnosis and treatment. Make sure you talk to your doctor about scheduling that long-overdue screening mammogram.
UPDATE: I spoke with Fox 4's Heather Hays on October 20 about the new American Cancer Society mammogram guidelines.
Texas law prohibits hospitals from practicing medicine. The physicians on the Methodist Health System medical staff are independent practitioners who are not employees or agents of Methodist Health System.
Dr. Gandhi’s areas of specialty include hematology and oncology.