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Metastatic Breast Cancer Patients
Part 2
What exactly is considered metastatic breast cancer? Metastatic breast cancer (Stage IV) is serious and the survival rate is considerably less than for women whose cancer is confined to the breast or axillary (underarm) lymph nodes. Breast cancer has the potential to spread to almost any region of the body. The most common region is bone, followed by the lung and liver.
Previously I covered the changes in the delivery of the drug Paclitaxel, which has been a beast cancer therapy mainstay since the 1990s. Another example related to Paclitaxel is a new derivative of Paclitaxel called Abraxane. In this instance they have reformulated the Paclitaxel into a little albumin shell for delivery. When you do that, the drug dissolves better in water and patients dont get allergic reactions, a significant advance in treatment comfort.
Still a third example of this trend in reformulating long-used medicines is the drug Capecitabine. Capecitabine is an orally available form of chemotherapy, but its a very old chemotherapy called 5-FU. Results showed that when 5-FU was used by giving it in squirts in a clinical setting, it wasnt all that effective. By developing this drug into a pill form, you more or less mimic a continuous exposure to the drug, and it results in Capecitabine, which is marketed as Xeloda, becoming a very effective way of controlling breast cancer.
A different treatment option for women with metastatic breast cancer is combining other therapies with long-used treatments. Patients are now being tested for the HER2/new gene protein to determine if they are eligible for “targeted” therapy. Tumors that are HER2-positive are candidates for treatment with a new anti-HER2 drug called Herceptin.
Herceptin is an antibody therapy in which an antibody that is targeted to the HER2/new protein is added to chemotherapy. In clinical trials this approach has shown impressive results. Adding Herceptin doubled the response rate to chemotherapy alone, substantially improved the length of time before the tumor got worse and contributed to much improved overall survival for women with HER2-positive breast cancer.
For patients whose breast cancer has spread to the bone, they may be treated with bone strengthening drugs called bisphosphonates. It alleviates some of the pain, it helps prevent fractures and it prevents the excessive absorption of bone which can give rise to something called hypercalcemia, when theres so much calcium thats leached out of the bone into the bloodstream its actually bad for the patient.
There is a great deal of progress being made on many fronts to improve the prognosis for metastatic breast cancer patients. Many new therapies are being tested in clinical trials ongoing today. There is a veritable explosion right now in biotechnology drug development, so there are a tremendous numbers of drugs that are flooding onto the market for clinical trials in breast cancer.
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