It is a first sword of world oncology. A recent American ranking positions him as the number one expert in knowledge and experience (‘expertise’) of one of the subtypes of breast cancer biologically more aggressive, HER2+. Javier Cortes, founder and director of the International Breast Cancer Center (IBCC), lives, as he confesses to ABC, “a bittersweet moment.” «On the one hand, -he explains- I am proud of this recognition, the result of the repercussion that our work has had in the last ten years; but, on the other hand, I feel a certain bitterness because despite the progress made in the fight against breast cancer, 2.3 million new cases and 685,000 deaths from the disease continue to be declared in the world every year». Its star contribution, which has marked a before and after in the therapeutic approach to this tumor of hormonal origin: the drug trastuzumab-deruxtecan, which acts as a Trojan horse in the body, effectively stopping the progression of the disease, It is not yet prescribed in Spain. In this sense, Cortés underlines the level of excellence of oncology research in Spain, but regrets that our country “is not yet up to the task of approving drugs.”
– Giant steps have been taken in global oncology research. One of them has been the contribution of the ‘Destiny-Breast 03’ study led by his team with trastuzumab-deruxtecan. Why has it marked a before and after in the fight against breast cancer?
-Without a doubt, it is the most active drug against this disease. Probably the most relevant and impressive results in the history of breast cancer have been obtained with it. We are almost quadrupling the efficacy we had with conventional treatment. Trastuzumab-deruxtecan works like a Trojan horse. An antibody with a backpack with chemotherapy molecules circumvents our body’s defenses, reaches the cell membrane, crosses it and once inside releases the drug. 80% of the patients treated with it showed a very important response, and in 16% of the cases the disease disappeared. I am convinced that in the very near future this treatment will give very good data on survival.
-Is its use approved in our country for breast cancer?
-Still unmanageable. Spain has a very good level of oncology but in the approval of drugs it is not yet up to the task. It is incredible that patients with breast cancer continue to die in our country without having been treated with drugs that have shown their effectiveness and are already approved by the European Medicines Agency. The Ministry does not have all the responsibility. It has it in that a drug approved in Europe should be able to be administered in Spain, although we all know that there are other factors that weigh in on this decision such as the price of the drug, the benefit limited by the price, etc… The cost of some drugs is today very high. Spain cannot pay these amounts and that involves private insurers in the problem.
-What other great advances are predicted in the near future?
-We will continue to advance in developing more combinations of drugs that allow us to continue improving disease control by targeting the tumor microenvironment; We also work on optimizing Trojan horses and soldiers. We studied whether the antibodies carry two chemotherapy agents in the backpack and not one, or whether the drug is directed at two receptors.
-For when the chronification of breast cancer?
-We will probably see it in a large number of patients in about 15-20 years.
-There is talk of humanistic medicine, is it practiced as much as it would be necessary?
-Every time we are better technicians and worse doctors. We forgot to hold the patient’s hand.
-Is too much surgery prescribed for breast cancer?
-Yes, on too many occasions the surgical treatment is still done hastily. Cancer is a slow disease. That is why the second diagnosis is very important. Previous surgery can often lead to a worse prognosis.
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