Breast Cancer in the News: Latest Research Breakthroughs
Our monthly update includes the latest news about breast cancer – and what you should understand about it.
Pfizer’s palbociclib: the next Herceptin – or the next Avastin?
New drugs and drug combinations to help prevent breast cancer (or its spread) are constantly making their way through the clinical trial process, hoping to eventually gain FDA approval – along with the potential of billion-dollar sales for their manufacturers.
Most drugs don’t make it, derailed by inconsistent results, devastating side effects, or simple failure to prove effective.
Some gain FDA approval, only to lose it when longer-term studies don’t continue to show a proven benefit. Avastin, which at first showed promise in treating metastatic breast cancer, later lost its FDA approval when longer-term studies showed that, while it slowed tumor growth, it neither reduced mortality, nor improved quality of life.
Herceptin, on the other hand, is a drug that successfully negotiated clinical trials, gained FDA approval in 1998, and has been effectively treating women with HER2+ breast cancer ever since.
Now palbociclib, a drug being tested for use in women with metastatic, hormone-receptive breast cancer, is being termed “the next blockbuster” in various media reports aired earlier this month.
Why? Because pairing palbociclib with Femara, a familiar aromatase inhibitor already prescribed to millions of survivors, doubled the amount of time tumor growth stalled, compared to current drugs.
Well, that’s good, right? Yes, but… The study was so small (involving only 165 women), and so recent (it’s ongoing), that there’s no evidence that palbociclib actually prolongs life. In addition, it comes with some fairly serious side effects, including anemia, fatigue, and low white blood cell counts.
Pfizer is pushing ahead with stage 3 clinical trials, in hopes that as time progresses, palbociclib will become a proven life-extender for survivors with metastatic breast cancer.
In the meantime, if you’re a post-menopausal survivor with hormone-receptive cancer facing a stage 4 diagnosis, you might want to check out Paloma-2, Pfizer’s ongoing clinical trial for palbociclib. Participating in a clinical trial helps advance research, and ultimately benefits us all.
Why is breast cancer fatal in black women more often than it is in white women? A new analysis
The good news is, over the last 20 years, the rate of U.S. women dying from breast cancer has dropped. The bad news is, this reduction in death rate isn’t happening as quickly for black women as it is for whites.
A new study released last month says that access to screening and good health care, rather than racial or genetic differences, accounts for the majority of this growing disparity.
The 20-year study, begun in 1990, includes data collected in America’s 41 largest cities. Mortality rates were examined in 5-year increments. By the time the study concluded in 2009, white women’s mortality due to breast cancer had fallen by 27%; while that of black women had fallen by just 13%. In addition, that gap widened from the beginning to the end of the study.
It’s a fact that younger (pre-menopausal) black women are more likely than white women to be diagnosed with aggressive, hard-to-treat breast cancer; and black women are more likely to suffer from underlying conditions (e.g., diabetes, high blood pressure) that worsen cancer outcomes.
However, the study authors note that these biological differences alone can’t account for black women’s comparatively greater mortality, since outcomes among blacks and whites in some cities (e.g., Minneapolis) are minimal, while there’s a large difference in others (e.g., Chicago). Note: the study doesn’t include Asian or Hispanic women.
The study authors conclude, “Attention will continue to be paid to genetic solutions to the disparity in breast cancer mortality. This is inevitable given the disproportionate share of the funding available for such approaches. What we humbly propose, however, is that first we try providing equal access to quality early detection and treatment, and determine the progress that we can make there.” (Hunt, 2014)
Adds Dr. Otis Brawley, chief medical officer for the American Cancer Society, “Most of the disparities are actually due to access to care and access to quality care. This is an ethical and moral problem that we in the United States have yet to come to grips with.” (Huggins, 2014)
Breast cancer treatment took another step towards personalization recently, as researchers released a study that used the complete genetic profiles of women with metastatic breast cancer to determine which treatments might work best for each individual woman, based on her DNA.
The French study, involving more than 400 patients, aimed to match specific genetic alterations with the success or failure of current treatments, as well as with those in clinical trials. Using their DNA, researchers were able to determine that almost half of the women would be helped by proven, current treatments; while another 39% had genetic alterations that wouldn’t respond to any treatments currently in use.
What does this mean for the future of breast cancer treatment – as well as the potential risk each of us should be aware of?
As scientists continue to match genetic alterations with specific outcomes around breast cancer, they’ll be able to pinpoint which alterations are dangerous, and which not. While testing for the cancer-causing BRCA1 and BRCA2 genetic mutations is common right now, in the future scientists should be able to compile a woman’s complete genetic profile – examine every gene, all at once – and in the process determine her own potential risk of breast cancer; and, should she at some point be diagnosed with cancer, the best possible treatment plan.
Can a simple blood test predict cancer recurrence risk?
Yes, says a research team at Baltimore’s Johns Hopkins Kimmel Cancer Center, which published their findings in the April 15 edition of the journal Cancer Research.
While the study is small in scope, its results are definitive: by examining specific genes in the patients’ blood, the test proved about 90% accurate in identifying which genetic mutations led to cancer recurrence.
The study explains that normal cells are programmed to fight uncontrolled growth: cancer. But sometimes normal cells undergo “hypermethylation” – a process that stops them from fighting this uncontrolled growth. And at this point, cancer can grow.
Scientists have identified 10 specific genes related to breast cancer, and by checking these genes for hypermethylation, are able to predict whether or not an early breast cancer will metastasize.
In addition, the researchers noted the same test, dubbed cMethDNA, can be used to assess how well chemotherapy is working – as quickly as 2 weeks after the start of treatment.
This preliminary research will soon become the basis for a clinical trial, according to lead author Saraswati Sukumar, who noted that further research on a larger group of women needs to be completed. She predicts it’ll be at least 5 years before the cMethDNA test is generally available to doctors.
Armstrong, D. (2014, April 06). Pfizer breast cancer drug helps revive discarded strategy. Retrieved from http://www.businessweek.com/news/2014-04-06/pfizer-breast-cancer-drug-helps-revive-discarded-strategy
Doheny, K. (2014, February 07). Expanded DNA testing might allow personalized breast cancer treatment. Retrieved from http://consumer.healthday.com/cancer-information-5/breast-cancer-news-94/whole-genome-testing-may-help-id-best-treatment-for-advanced-breast-cancer-684610.html
Huggins, C. E. (2014, March 21). Black-white disparities widening in U.S. breast cancer deaths. Retrieved from http://www.reuters.com/article/2014/03/21/us-breast-cancer-idUSBREA2K1SJ20140321
Hunt BR, et al. Increasing black/white disparities in breast cancer mortality in the 50 largest cities in the United States. Retrieved from Cancer Epidemiology (2013), http://dx.doi.org/10.1016/j.canep.2013.09.009
Whiteman, H. (2014, April 16). New blood test 'accurately predicts breast cancer recurrence'. Retrieved from http://www.medicalnewstoday.com/articles/275535.php