Adding targeted therapy to standard hormone care after surgery lowers the chances of relapse and metastasis in patients who have been diagnosed in the early stages but with a life-threatening neoplasm
One in eight women in Italy will get breast cancer in their lifetime. With 55,000 new cases diagnosed in 2020 and 37 thousand Italians living with a metastatic neoplasm, this cancer is the most widespread not only among females, but in the entire population. Despite the many advances made (fortunately 87% of patients live 5 years after diagnosis) remains the first cause of death from cancer among Italians. Several trials presented during the Congress of the European Society of Medical Oncology (ESMO) point to new effective strategies to extend life, even in those who already have metastases, and reduce the risk of relapse. The results of the MonarchE study go in this sense, demonstrating an improvement in invasive disease-free survival by adding the drug abemaciclib to standard endocrine therapy.
The experimentation
Abemaciclib a highly effective selective inhibitor (affects the so-called cyclin-dependent kinases, CDK 4/6), able to prolong disease control in patients with hormone-sensitive breast cancer: those positive for the hormone receptor (HR +) and negative for the human epidermal growth factor receptor (HER2-). They are women with a high risk of the disease returning after surgery and this drug, added to standard adjuvant endocrine therapy, had already significantly improved recovery-free survival of the cancer. The new results of the phase three MonarchE trial confirm the 2020 data, improving them: a longer observation period (the participants were followed on average for over 27 months), the benefit remains in reducing the risk of relapses, at the to which are added a 30.4% decrease in the risk of recurrence and 31.3% in that of metastasis. These data are of great interest because they confirm the positive outcome of the study and the clinical benefit of the combination of abemaciclib and hormone therapy to a longer observation time – he explains Valentina Guarneri, full professor of medical oncology and director of the complex operational unit of oncology 2 at the Istituto Oncologico Veneto IRCCS -. The fact that distant metastases are reduced above all makes the data even more solid. The aspect of the toxicity: with nearly 90% of participants finishing the treatment, we can definitely consider it safe and well tolerated.
Symptoms not to be overlooked
80% of women who are diagnosed with breast cancer are over the age of 50, but the incidence in the 30-40 year olds is growing. The chances of recovery, if diagnosed early, are very high and for this reason it is good to carry out regular checks, do breast self-examination at least once a month and do not neglect the possible alarm bells. The most common symptom the presence of a lump that does not cause pain and has irregular contours. Other frequent signs are the swelling of part or all of the breast, the transformation of the skin that tends to become orange peel, changes in the shape of the breast such as the presence of depressions, changes in the nipple (outside or inside ), discharge of fluid or blood from the nipple, swelling of the lymph nodes in the armpit, around the collarbone or neck. In all these cases it is necessary to consult your doctor who may request the most appropriate tests. It was since the early 2000s, when aromatase inhibitors were introduced, that we had not seen substantial clinical improvements in adjuvant therapy, i.e. post-surgery, of hormone receptor positive breast cancer, which is the most common type of breast cancer. diagnosed – concludes Lucia Del Mastro, director of the Breast Unit of the San Martino Polyclinic Hospital and professor of Oncology at the University of Genoa -. About 65% of all breast cancer cases are hormone receptor positive cases, so advances in this cancer subtype are of particular relevance. We will have an important additional weapon to use against breast cancer at high risk of recurrence: the drug has just been approved by the FDA regulatory agency in the United States and we hope it will soon be available in Italy as well.
October 26, 2021 (change October 26, 2021 | 10:42)
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