Science will continue to drive change in breast cancer treatment : Dr Murali Subramanian


Breast Cancer Treatment Near Me in Bangalore | Dr. Murali Subramanian, Medical Director, Oncology India, discuss about science has been a sea change in the way cancer is treated today, in a much more personalized manner, rather than a generic path for every cancer patient.
Rapid advances have been made in healthcare in the last few decades. Cancer treatment in particular, has seen tremendous progress, to the point where a once fatal diagnosis is now considered treatable. The drivers of these dramatic changes have been advances in science and technology. Despite increasing incidence of breast cancer, over the last two decades, advances in diagnostic techniques and more effective treatment options have significantly improved cancer survival rates. Especially in breast cancer, many studies have shown that if detected early enough, the majority of breast cancer patients can be cured.
Early Breast Cancer
A lot of research has gone into understanding the biology of cancer and developing newer and safer drugs and treatment modalities. This has led to a sea change in the way cancer is treated today, in a much more personalized manner, rather than a generic path for every cancer patient. New research has also paved the way for de-escalating treatment in certain types of cancers, especially early-stage Hormone positive breast cancers. For breast cancer, there exists many such prognostic tests which assess biomarkers in a patient’s tumor to determine how likely it is that the tumor will grow to cause a metastasis.
A recent pivotal clinical trial TAILORx involving over 10,000 early-stage breast cancer patients demonstrated that up to 70% of early-stage breast cancer patients may not need chemotherapy. Personalization of treatment can be game-changing in many ways – one, it can lead to improved quality of life for many patients, two, it can lead to huge cost savings for the patient in a country like India where most healthcare expenditure is out of pocket and lastly, it can lead to more optimized use of healthcare resources. In today’s era of personalized treatment, prognostic tests are gaining popularity in customizing treatment for early-stage hormone-positive breast cancer patients. While there are several Western tests available these are expensive, therefore routine use of these tests is not feasible in developing countries. There are affordable tests that are developed in India and validated on Indian patients. Larger clinical trials are ongoing and the data looks promising.
Another promising area of personalized medicine is targeted therapy. Targeted treatment is different from traditional chemotherapy, which kills all fast-growing cells in the body. Targeted therapy involves drugs or other substances that block the growth and spread of cancer by interfering with the specific molecules that are involved in cancer growth and survival. For example, the targeted therapy Trastuzumab is used to treat women with breast cancer that overexpresses the protein HER2/neu. Other drugs targeting Her 2 neu are Lapatinib, Pertuzumab etc. Use of Trastuzumab along with chemotherapy in early Breast cancer has proven to decrease the risk of recurrence by 50 percent.
Advanced Breast cancer
Chemotherapy is still an integral part of treatment for the aggressive type of Breast cancers like HER 2 Positive and TNBC. Together with targeted therapies, they will have an additive effect. Many Novel anti Her 2 Targeted therapies (in addition to the drugs already mentioned) are in various phases of development in patients with advanced Breast Cancer. In patients with advanced Hormone positive Breast cancer Novel class of drugs called CDK4/6 INHIBITORS have vastly improved the outcomes of treatment. These drugs give the best results when used in combination with another class of drugs called Aromatase inhibitors.
Latest Exciting development in cancer treatment is immunotherapy, which taps into the ability of using a person’s own immune system to fight cancer. Various immunotherapies have been approved by the FDA, and have been used to treat patients with advanced Cancers. The FDA recently approved an immunotherapy drug, Atezolizumab, for the treatment of Advanced Breast cancer for a particular subtype called Triple Negative Breast Cancer(TNBC).
Therefore future of cancer medicine lies in personalized treatment, and as oncologists, we hope that science and technology continue to drive change in cancer treatment, so that every patient has a fighting chance.

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