27 6月 Metastatic Breast Cancer – PROGRESS and HOPE
BY JENNIFER MURAR-MAXON, RN, BSN
As cancer treatment enters a new era of personalized medicine, progress and hope have become a new mantra for those diagnosed with metastatic breast cancer (MBC). For many patients living with MBC, their focus is on living each day with quality, coupled with the understanding that novel treatments are now providing long-term survival for many.
Metastatic breast cancer refers to cancer that originates in the breast but has spread to one or more other locations in the body, such as the lungs, liver, or bones. The majority of patients with MBC have experienced a recurrence following a prior diagnosis of earlier-stage disease; however, patients can also be diagnosed initially with this advanced form of breast cancer.
Although the majority of patients diagnosed with MBC have not historically been considered to have curable disease, more-advanced precision treatment options that are tailored to an individual cancer’s characteristics continue to be developed and are improving long-term survival rates and quality of life. Importantly, extensive research is currently under way, with the promise of even greater individual- ized treatment options in the future for patients with MBC.
Historically, a diagnosis of MBC had a poor prognosis, and its treatmen —most often chemotherapy and radiation- was associated with severe side effects and a poor quality of life. Although chemotherapy and radiation are still important treatment components for many women with MBC, these therapies have been refined, and supportive care measures have improved significantly to limit side effects associated with these types of treatment.
The development of newer therapies, however, is what has led to the most significant improvement in survival and quality of life for individuals with MBC. In particular, new-generation hormonal therapies, targeted therapies, testing of a patient’s cancer cells to determine if they will respond to certain therapies, and the ability of patients to tolerate several sequential therapies—all have brought about significant improvements in the way MBC is treated.
Currently, more than one-quarter of patients diagnosed with MBC can expect to survive at least five years, and some live more than 10 years. Moreover, the rapid emergence of novel therapies continues to increase survival rates and improve quality of life.
Georgi Delgadillo, a 57-year-old middle-school science teacher, was diagnosed with MBC in 2013, following an initial diagnosis of Stage I breast cancer in 2011. After undergoing extensive therapy for MBC, Georgi received the devastating news that the cancer had stopped responding to the last medication for which she was eligible. She was at the end of the road in terms of available treatment options for that type of cancer.
Fortunately, within a week of her receiving this crushing news, Ibrance® (palbociclib), a novel targeted agent, was approved by the US Food and Drug Administration for the treatment of the particular type of cancer Georgi had. She immediately began treatment with Ibrance, and the drug has been effective: during Georgi’s most recent appointment, her oncologist told her that the cancer was in remission.
Because several new drugs and treatment approaches for MBC are progressing through late-stage development, Georgi remains “very hopeful” that if the cancer stops responding to Ibrance, there is a good chance that an- other treatment will become available.
Heather Nichols, MD, clinical faculty at Family Residency of Idaho, agrees. “I think that treatment for cancer will continue to become extremely individualized, based on a cancer’s genetic profile and molecular markers, marking a new era of treatment options for this disease,” she says. “The medical students in residency whom I work with now will most likely be dealing with very different treatment approaches for cancer a few years into their own practices.”