Tuesday, October 25, 2016

No Cure Yet for Breast Cancer, but 3 Big Advances in 2016

In the U.S., one in eight women will be diagnosed with breast cancer in her lifetime. I became one of those eight women a decade ago and endured the go-to treatment at the time for breast cancer -- chemotherapy, surgery, radiation, with ensuing hair loss and constant nausea. But there's great news for all women. That toxic regimen may be headed out the door, because breast cancer treatment is rapidly moving to a more personalized and targeted paradigm that could save millions of lives and drastically change the quality of life of patients. Here are three dramatic advances that are leading to more effective treatments, as well as brand new ways to think about what causes the deadly disease. 

Targeted combo therapy completely obliterates signs of cancer

The biggest advance of 2016 in breast cancer has to be how a combination of targeted cancer drugs completely obliterated all signs of breast cancer in 11% of patients in only 11 days.

The UK-based study involved 257 women with particularly virulent type of breast cancer (HER2-positive), and combined two drugs from GlaxoSmithKline (NYSE:GSK) and Roche Holdings (NASDAQOTH:RHHBY). While 11% may not seem that impressive, for even one breast cancer tumor to be completely eradicated by a drug in less than two weeks is electrifying. Cancer tumors develop resistance to chemotherapy agents so rapidly, these drugs often have no impact on a tumor even after many months of treatment. Instead, tumors are removed surgically first. Chemotherapy comes afterwards -- to mop up stray cancer cells that might have spread elsewhere in the body.

In the past few years, a small minority of women have been having chemotherapy first. While that regimen sometimes shrinks the size of tumors, typically the order is reversed because the oncologist is more concerned about where the cancer could be going rather than the primary tumor. But Glaxo and Roche's drugs -- Herceptin and Tykerb -- are not infused chemotherapies, but simple oral pills. In addition, these drugs are highly targeted treatments, and attack cancer cells specifically. That's a huge plus because patients do not have to deal with the severe side effects of chemotherapy, which kills all rapidly dividing cells in the body like hair follicles and healthy bone marrow cells. Better yet, there is a large arsenal of these new therapies already on the market, including monoclonal antibodies like Herceptin and Tykerb, checkpoint products such as PD-1, and other treatments that unleash the power of the patient's immune system.

As was seen in the Glaxo/Roche drug trial, pairing these drugs together in a one-two punch is raising the success level of treatment and may eventually point the way to a cure.

93 genes causing breast cancer identified

This May, UK-based researchers at Cambridge Research Institute, unpacked the whole picture of what genetic events could be causing breast cancer. Thanks to their efforts, we should soon have a much better idea why the disease strikes certain individuals. Specifically, the scientists found 93 genes whose mutations convert a normal breast cell into a cancer cell. Professor Mike Straton, who led the study, said the list "would be handed over to the universities, the pharmaceuticals, the biotech companies to start developing new drugs."

It's hard to overstate how big this win is. The more we know about the genetics of cancer, the more we will know about what treatments will work for an individual women, paving the way to much higher survival rates.

Blood test could replace mammograms

Another huge breakthrough this year brought us much closer to a blood test for breast cancer. Specifically, researchers in France and Australiareported that a change in the isotopic proportions of carbon-13 and nitrogen-15 can reveal the presence of the disease. With this new way of detecting breast cancer, the project's lead researcher Professor Guillaume Tcherkez said we could have a simple blood test in a few years. That's terrific news for women, because mammograms, the best method currently available, are inaccurate 16% of the time. The resulting misdiagnosis includes highly stressful false positives, where the screening incorrectly shows breast cancer, and potentially fatal false negatives, where the mammogram fails to detect cancer. An innovative breast cancer blood test is already being developed in France, while here in the U.S. gene sequencing powerhouse Illumina (NASDAQ:ILMN) is working on all-in-one liquid cancer biopsy that can detect virtually any cancer. Illumina has said an early version of that test should be on the market in three years. If that goal is achieved, many forms of cancer will be found earlier, when it tends to be treatable, which should massively decrease the world's cancer mortality. 

How to take advantage of cancer breakthroughs

Anyone at risk of breast cancer -- which includes all women, and although much more rarely, all men -- strongly benefits from being informed about breast cancer breakthroughs. The disease strikes without warning, and with the flood of new treatments reaching the market, many doctors have never prescribed some of them and may be hesitant, or even uniformed, about their possible benefits. In fact, taking charge of your own health is the best way to beat this disease. That doesn't mean you should ignore your doctors' advice, but that you should diligently practice ways to prevent cancer such as eating a healthy diet and exercise, make sure you get necessary screenings, ask questions if you are diagnosed, and seek a second opinion if you are not satisfied with the answers.

While survival rates have doubled over the past 20 years, a women still dies from breast cancer every 12 minutes in the United States. So never forget, this disease presents a serious threat to your life and no one cares about your life more than you do. But there's no reason to end on a somber note, because research is now showing how powerfully our own bodies can be mobilized to fight it. That's not only improving the odds for survival; it's also bringing us closer to the day when we can finally claim a cure.

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