October is Breast Cancer Awareness Month, and unfortunately, many of us are already way too aware of its existence because we either know someone diagnosed with it or are fighting it ourselves.
According to breastcancer.org, about 1 in 8 women in the United States will develop invasive breast cancer throughout her lifetime, and it is the second leading cause of cancer deaths in women, falling in behind lung cancer. Unfortunately, one “gold standard” therapy for treating hormone receptive breast cancer is now in question by scientists, as it might not be as effective as once thought. However, on the opposite end of the spectrum, groundbreaking new treatments are emerging that show promise at not just treating breast cancer, but potentially eradicating the disease.
For estrogen-receptive malignancies, which make up approximately two-thirds of all breast cancers, the typical course of treatment is the removal of the tumors via lumpectomy or mastectomy, and then implementing a type of hormone therapy into the treatment plan. Depending on the stage of the disease, some patients undergo chemotherapy or radiation as well.
In a September 2019 article published in the journal Nature Communications
, scientists tackled the question as to why breast cancer reoccurs in some patients after hormone-based treatment. The team of researchers looked closely at around 50,000 hormone-receptive human breast cancer cells to determine why some are eliminated by the hormone therapy known as adjuvant endocrine therapy treatment, and some are not. Interestingly, the team discovered that when malignant cells were exposed to the hormone therapy, although most of the cells were killed, some instead fell into a dormant state, remaining a potential cause of relapse. Although researchers can’t determine how these “sleeper” cells go dormant or what triggers them to reawaken, they do suggest that these cells are more likely to travel around the body, potentially becoming a source of metastasized breast cancer.
On the upside, there are two new groundbreaking treatments on the edge of becoming mainstream if clinical trials are successful. During the European Society of Medical Oncology (ESMO) 2019 annual meeting, researchers presented findings from the MONARCH 2 and MONALEESA-3 trials, which showed an increased survival rate for women with hormone receptor-positive, human epidermal receptor-negative advanced breast cancer when a class of drugs called CDK4/6 inhibitors was added to their therapy regimen. In a September 2019 Medscape article, Dennis J. Slamon, MD, PhD, from the David Geffen School of Medicine at the University of California, Los Angeles said, “this is a practice-changing report, in that we are now saying that patients with advanced breast cancer will have an overall survival benefit if they get the CDK4/6 inhibitor, ribociclib, upfront at the time of their recurrence, even if they have not had any prior endocrine therapy at the time of presenting with metastatic disease.”
The Mayo Clinic has been making some headway of their own with their new “breast cancer vaccine,” that according to a Forbes
article published online on Oct. 11, 2019, may not only stop the recurrence of breast and ovarian cancers, but prevent them from developing in the first place. In the article, Mayo Clinic investigator, Keith L. Knutson, Ph.D. said although the vaccine is in its early stages of research, it could be available to patients through their pharmacy or their doctor within eight years. Knutson says the vaccine stimulates the immune system to fight cancer and has shown positive results on both ovarian and breast malignancies without adverse side effects. According to the Mayo Clinic, this vaccine bolsters the immune system against the HER2 protein, which is found in the majority of women with a noninvasive breast cancer called ductal carcinoma in situ, or DCIS. Researchers are hopeful it retrains the patient’s immune system to target these proteins and kill them.
Although this disease is devastating to patients and their families, the current survival rate is surprisingly good. According to the American Society of Clinical Oncology (ASCO), if the cancer is located only in the breast, which is the case in about 62% of people diagnosed, the five-year survival rate of women with breast cancer is 99%. If the malignant cells have spread to the regional lymph nodes, the five-year survival rate is 85%. However, if it has spread to a distant part of the body, the five-year survival rate is 27%.
Hopefully, the rapid advancements in new treatments will make breast cancer a 100% curable disease, or better yet, eliminate it entirely, making this common and devastating type of cancer a thing of the past.
Kimberly Drake can be reached at [email protected]