Breast Cancer What's New In 2013?
With October as breast cancer awareness month, I would like to give an update on what is new in breast cancer during 2013.
First of all, the standard of care for the last four decades has been five years of adjuvant tamoxifen in ER+ breast cancer after surgery. Recent data revealed that 10 years of adjuvant tamoxifen is in fact superior as far as decreasing recurrence rates and death from the disease and is currently the new standard of care. Life expectancy and high versus low risk of recurrence will also play a role when choosing length of therapy.
With regard to metastatic estrogen receptor positive patients, two changes occurred this year. Doubling the dose of fulvestrant (faslodex) from 250mg to 500mg (IM injection given monthly) increased overall survival.
The second important change was adding everolimus (an M-tor inhibitor) to the aromatase inhibitor anastrozole improved response rates as well as progression free survival leading to FDA approval of the combination therapy.
New data in Her-2-NEU positive disease in the metastatic setting revealed that adding pertuzmub to trastuzmab and docetaxel (dual HER-2-NEU blockade) improved progression free as well as overall survival.
A new drug was also FDA approved for HER-2-NEU metastatic breast cancer called TDM1, which is a combination of trastuzmab plus emtasine (a powerful cytotoxic agent) that has proven to be very effective as single agent surpassing some combination therapies.
With the increasing understanding of the biology of the numerous different types of breast cancer, new molecular abnormalities are being discovered that will be targets for new treatments in the future.