Up to a third of breast cancers can return later in life and the survival rate is alarmingly low when it does. It’s not only researchers who have questions on how to improve these figures, many in the community also want answers about metastatic breast cancer.
To help provide some clarity and answer questions from the community on metastatic breast cancer, the National Breast Cancer Foundation hosted Professor Robin Anderson from the Olivia Newton-John Cancer Research Centre for a live Q&A on Facebook.
A very experienced breast cancer researcher, Professor Robin Anderson is investigating the reason breast cancer may stay dormant in the body after initial treatment and what triggers it to return. Her aim is to see if the tumour cells can be made to stay in their harmless dormant state and if the point at which their growth is triggered can be prevented.
Participants in the live event were interested to tap into Professor Anderson’s expert knowledge on research, trials and treatments for metastatic breast cancer. Here is a recap of the highlights:
Question: I’m interested in research being done on Her2 metastatic breast cancer…. will treatments like herceptin and pertuzumab still need to be performed in a hospital?
Professor Anderson: There is extensive research both here in Australia and overseas on the development of new treatments for metastatic Her2 positive breast cancer. There are many clinical trials underway testing new drugs that target Her2 and the downstream genes that Her2 activates. Many of these are showing promise even in patients who have relapsed used Trastuzumab (Herceptin) alone.
Herceptin and Pertuzumab are antibodies, which are large proteins and it is very difficult to make these available through an oral pill. If taken this way, the proteins would be broken down in the stomach. Hence, they are introduced directly into the bloodstream through an intravenous drip. Since they are delivered this way, it is necessary to be done under medical supervision, generally in a hospital or clinic setting.
Estrogen positive metastatic breast cancer
Question: Are there any breakthroughs/development in the treatment of estrogen positive metastatic breast cancer?
Professor Anderson: Research for improved therapies for estrogen positive breast cancer continues despite the good success with endocrine therapies such as tamoxifen or letrozole. A new targeted therapy called palbociclib (Ibrance) was approved in 2015 for patients who develop metastatic disease and in a clinical trial, 80% of women received benefit from this therapy. Ibrance was recently approved by the TGA for sale in Australia but unfortunately, is not yet listed on the PBS.
Triple negative breast cancer clinical trials
Question: “I was wondering what you think about the current trials using Keytruda for metastatic triple negative breast cancer and other immunotherapies or complementary drugs that would be helpful for this type of triple negative breast cancer.
Professor Anderson: Keytruda has proven to be very effective in several types of cancer, especially in melanoma. For breast cancer, use of Keytruda is a bit more challenging as only a subset of triple negative breast cancers (TNBC) seem to be responsive to this drug.
However, we are learning which TNBC are responsive and patients with this type of breast cancer are being treated successfully with Keytruda in clinical trials. I think that the future for immunotherapy for breast cancer patients lies in researchers having a better understanding of how the immune system detects breast cancers. When we understand this, and there is a lot of research in this area, we will hopefully develop immunotherapies that are as effective in breast cancer as they are in melanoma.
Keep up to date with the next live Q&A with a researcher on the National Breast Cancer Foundation’s Facebook page