Patients with two of the three most common types of advanced breast cancer now have a median survival time of at least five years, double that of a decade ago, as highlighted by a panel of experts at the Sixth International Consensus Conference on Advanced Breast Cancer.
When breast cancer spreads to other parts of the body (called advanced or metastatic breast cancer), it is more difficult to treat and consequently median survival times have been low. However, more research has been done on advanced breast cancer in the last ten years, which means that doctors now know much more about how to treat the disease.
In a session where new guidelines for the treatment of advanced breast cancer were agreed, these experts said that more work is needed to find treatments that are effective for the third type of advanced breast cancer, called triple negative), in which the mean survival time is still shorter.
The most common subtype of advanced breast cancer is known as hormone dependent or estrogen receptor positive (ER +) because its growth is fueled by the hormone estrogen. Another subtype is known as HER2 + because cancer cells make too much of a protein known as HER2, which stimulates their growth.
In the last decade, the median survival of these two advanced breast cancer subtypes, which together account for 85 percent of cases, has gone from one to two years to five. This means that half of the patients with these cancers can live more than five years, and some up to ten.
The third subtype, known as triple negative cancer because it does not feed on estrogen and does not overproduce HER2, has fewer treatment options, and consequently, patients have poorer survival.
In the past two years, hope has risen for this subtype as well, with two new treatments providing some survival benefit. In the new guidelines agreed on in advanced breast cancer, experts say that patients with this subtype should have access to these new drugs, govitecan sacituzumab and anti-PD-L1 agents, especially pembrolizumab.
A key goal of the Advanced Breast Cancer Conferences and the Global Advanced Breast Cancer Alliance is to double the survival of patients with the disease by 2025. “We have taken a big step toward our goal of doubling the mean time to patient survival, since we have achieved it in two of the three subtypes of advanced breast cancer “, commented the president of the Advanced Breast Cancer Conference, Professor Fátima Cardoso, director of the Breast Unit of the Champalimaud Cancer Center from Lisbon (Portugal).
Despite the fact that the disease “remains incurable,” Cardoso points out that it has “come a long way.” “It means that most of the patients have two or three more years of life, with a good quality of life as well. Survival has also improved in the case of patients with triple negative disease, but we have to do more for them, about all because it tends to affect younger people who often have young children to care for, “he pointed out.
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