Advanced stage breast cancer patients attain improvement with biomarker driven treatment

ADVANCED STAGE BREAST CANCER PATIENTS ATTAIN IMPROVEMENT WITH BIOMARKER-DRIVEN TREATMENT

MAY 3, 2021 @ 11.58AM

Biomarker-driven treatment targeted at inhibiting the PIK3 pathway while working synergistically alongside oestrogen-receptor blockers reduced cancer progression in HR+/HER2- advanced breast cancer patients with PIK3CA mutation.

Following the recent announcement of the results of Novartis’ global Phase III clinical trial, the medicines company today introduced a biomarker-driven treatment in Malaysia to halt the progression of advanced breast cancer in patients with HR+/HER2- type of cancer and harbouring mutations in the PIK3CA gene. Combination treatment with a new selective inhibitor of the PIK3CA molecule and traditional oestrogen-receptor blockers nearly doubled the duration of survival of patients with the HR+/HER2- advanced breast cancer subtype compared to just oestrogen receptor blocker alone.

Dr Balraj Sethi, Country Medical Director for Oncology Division of Novartis said, “We have long suspected that combating the effects of the PIK3CA gene and its pathways were key to halting the progression of HR+/HER2- advanced breast cancer and improving the odds of survival. With the recurrent and progressive nature of advanced breast cancer, clinicians have long sought for answers on how best to tailor their treatment regimes. Now, we finally have an answer for patients with this particular genetic mutation.”

Advanced breast cancer
Over the past decade, Malaysia has seen a significant increase in breast cancer cases. According to the Malaysia National Cancer Registry Report (MNCRR) 2012-2016, roughly 34 women out of 100,000 developed breast cancer between 2012-2016, compared to about 31 women between 2007-2011. Currently, breast cancer remains the most common cancer affecting women and ranks second amongst the leading causes of cancer-related death in our country.

Many of the breast cancer-related deaths can be attributed to advanced breast cancer. Also known as secondary or metastatic breast cancer, it is defined by the spread of cancer cells to other parts of the body such as the lymph nodes, bone, lungs, liver or brain.

While previously presumed to be a disease affecting elderly women, more recent statistics and studies have shown that younger, pre-menopausal women are also susceptible to the disease. In fact, advanced breast cancer in pre-menopausal women tends to be more aggressive with a higher risk of recurrence, leading to an increased mortality risk. According to Dr Mastura Md Yusof, Consultant Clinical Oncologist, Pantai Hospital Kuala Lumpur, “Younger women with breast cancer also suffer from the added pressure of having to work full-time and care for their children while managing the disease”.

What is PIK3CA?
Advanced breast cancer is typically divided into different subtypes with specific receptors which include hormone receptors (HR+ or HR-) and human epidermal growth factor receptor-2 (HER2+ or HER2-). The subclassification is crucial in order for clinicians to select treatment regimens that can effectively combat and treat the disease.

However, further genetic testing of breast cancer tumours has revealed that approximately 40% of women with HR+/HER2- advanced breast cancer (the most common type) also had the PIK3CA mutation, which was linked to tumour growth, resistance to endocrine treatment and an overall poor prognosis.

“In each type of cancer, gene mutations play a role in determining how rapidly or invasive a cancer may become. In the case of HR+/HER2- advanced breast cancer patients, the PIK3CA mutation found within the tumour can tell us whether this gene mutation may be contributing to the progression of the disease and this gives rise to the question: Whether we can target it with medicines to control it?” said Dr Mastura.

How targeted biomarker-driven therapy improves survival
According to the Malaysian National Cancer Registry Report 2012-2016, 34 out of 100,000 Malaysian women are diagnosed with breast cancer in Malaysia and almost half (47.9%) of new breast cancer diagnoses were detected late, at the more advanced stages of three and four.

“Nearly 50% of patients present with advanced breast cancer when initially diagnosed and many of them suffer from recurring disease or cancer progression after completing or while still on their hormone-based treatment albeit receiving optimal treatment. Now, with the support of the latest clinical data and availability of the PIK3CA gene mutation tests in Malaysia, these patients are encouraged to get screened for the mutation to see if they can benefit from this biomarker-driven treatment. In those found to be positive for PIK3CA, this treatment will help to inhibit cancer growth by acting together with standard oestrogen receptor-blockers that we use at present to better reduce cancer growth,” added Mastura.

“When dealing with complex disease like advanced breast cancer, we need to carefully tailor care to suit each individual patient,” said Balraj. “Ordering the right tests, like screening for the PIK3CA mutation, will help both patients and their healthcare teams to work collectively to identify and prescribe precise treatment options for their individual disease.”

​​ADVANCED STAGE BREAST CANCER PATIENTS ATTAIN IMPROVEMENT WITH BIOMARKER-DRIVEN TREATMENT

ADVANCED STAGE BREAST CANCER PATIENTS ATTAIN IMPROVEMENT WITH BIOMARKER-DRIVEN TREATMENT