An international team of scientists led by Spain recently presented data from a breast cancer treatment which is a wave of hope in the gray times in which we live. It is Trastuzumab deruxtecana combination of a targeted drug and a chemotherapy drug. The results are so good that the progression-free survival rate has increased from 34.1% with a previous combination with 75.8% with that.
So far, this much lower percentage has been achieved with a mixture of the same targeted drug, but a different chemotherapy: emtansine. It was considered a good choice in the existing possibilities against cancer HER2 positiveone of metastatic breast tumors more aggressive. But this new combination, tested in the DESTINY Breast03 clinical trial and presented in a study in The New England Journal of MedicineIt seems much more efficient.
Logically, it will be necessary to follow these patients with breast cancer longer, to make sure everything is going well. However, the results we have at this time give us plenty of reason to be optimistic. And it never hurts to stick with it.
Tens of thousands of breast cancer cases each year
According to data from the Spanish Society of Medical Oncology, in 2020 they were diagnosed in Spain 32,953 new cases of breast cancer. According to the Observatory of the Spanish Association against Cancer, in 2021 there were 34,333. 1 in 8 women in our country will have breast cancer throughout her life.
Fortunately, it is one of the tumors with the best prognosis if diagnosed early. In fact, the survival at stage I it is over 98%, while at stage IV it drops to 24%. This is why screening is so important. mammograms. However, the most aggressive tumors, such as HER2 positiveare much more serious.
In these cases, beyond surgery, it is important to have an effective treatment. As with other tumors, chemotherapy is the best weapon we have. The problem is that it can generate quite significant side effects, for also affect healthy cells. Also, if its effectiveness is spreading, it is not as useful as applying the medicine only where it is needed. That’s why it’s so useful to make drug combinations like the one described in this study, whose first author is Javier Cortes, director of the International Breast Cancer Center (IBCC) in Barcelona. But what exactly is this treatment for?
The treatment that behaves like a Trojan horse
This treatment consists of two parts: Trastuzumab and Deruxtecan. The first is an antibody, which binds specifically to HER2 receptorpresent in these tumors. Once it’s there, the tumor cells internalize it, so the second drug, which is a chemotherapy drug, can be released.
This, in the words of the scientists who have studied it, is practically the operation of a Trojan horse. The cells literally open the doors to the chemotherapeutic drug that will kill them.
The use of this breast cancer treatment is not really new. In fact, in Spain it has already been approved for severe cases with metastases, in which two other therapies directed against HER2 have already been tested before. However, with the results of phase III of this clinical trial it is also expected to be accepted for localized tumors without metastasis.
And it is not for less, because they have had very positive results. Not only because of this increase from 34.1% to 75.8%. Also because after one year of follow-up, 94.1% of patients were still alive. This, together with the other combination analyzed, represents a lower percentage, 85.9%. Moreover, in 16% of clinical trial participants, the disease not only stopped progressing after one year, but also totally disappeared. With the previous drug combination, it only disappeared in 8.7%.
According to statements by Javier Cortés to The countrythe result of this study indicates that “we are getting closer to the desired goal chronification of metastatic disease”. This means that it may not be completely curable, but it is possible for those affected to live with the disease. Something like what happened with HIV, which went from being an extremely deadly virus to one where infected people can have practically normal lives.
Don’t throw too many bells on the fly until you have data for a longer period. But at least after a year, it looks like the results are much better than with another more widely used treatment for breast cancer. Yes, there are reasons to be optimistic.