Therapies to combat cancer relapse

Therapies to combat cancer relapse

2023-06-05 11:51:49

From June 2 to 6, this edition of ASCO 2023 hosts the presentation of some 5,500 studies in which combinations of new generation drugs, such as immunotherapy and targeted therapies, with other conventional ones, such as chemotherapy, are positioned as clinical advances. to try to contain prevalent tumors, such as breast and lung, but also less frequent ones.

These are some of the advances presented at ASCO 2023:

Breast cancer: hormone therapy with an inhibitor reduces relapses

Combining hormone therapy with the inhibitor drug ribociclib reduces the risk of relapse in hormonal breast cancer, called luminal, the most common subtype, affecting 70% of patients.

These are the results of the phase III clinical trial NATALEE, led by the American researcher Dennis Slamonconsidered the father of target therapies for his work with the first antibody, trastuzumab, directed against an oncogene, HER2+ some twenty years ago, and which was the first treatment for breast cancer other than chemotherapy, in addition to starting personalized precision medicine.

Overall, the addition of ribociclib reduced the risk of recurrence by 25%.

Targeted therapy against lung cancer increases survival without recurrence

Treating patients with early and intermediate-stage EGFR-mutated non-small cell lung cancer (the vast majority of cases) with the targeted therapy osimertinib after surgery increases survival and the risk of recurrence.

The ADURA clinical trial, promoted by AstraZeneca, specifies that five years after the operation the risk of death was 51% lower in patients with this therapeutic strategy than in those who received the placebo.

The survival rate was also 88% for the first group and 78% among those who stayed on the placebo.

Ovarian cancer: drug combination allows you to live longer

People with newly diagnosed advanced ovarian cancer without a BRCA mutation who added the drugs durvalumab and olaparib to their usual treatment have better progression-free survival than those who received standard therapy alone (37, 3 months vs. 23).

Only 20% of all ovarian cancer cases are detected early. And when the disease is at stage III or higher, survival rates can be as low as 30%, according to the phase II DUO-O clinical trial funded by pharmaceutical company AstraZeneca.

ASCO recalls that although the United States Food and Drug Administration (FDA) has approved more therapies against ovarian cancer since 2014 than in the previous 60 years combined, the number of relapses remains high and is around two years .

Pharmaceutical industry exhibitor area at the ASCO 2023 conference in Chicago. EFE/Marta Garde

Optimizing breast cancer therapy allows avoiding chemo

Adapting therapy against breast cancer based on the response obtained in the process makes it possible to avoid chemotherapy for a third of the patients undergoing treatments who now resort to it by default,

In the phase II clinical trial PHERGain, promoted by the Spanish-American clinical oncology research company MEDSIR and led by Spanish doctors Javier Cortés, Antonio Llombart-Cussac and José Pérez356 patients older than 18 years with early-stage operable HER2+ breast cancer participated in the study.

Group A received a combination of chemo and drugs trastuzumab and pertuzumab, while group B was treated adaptively, with the intention of avoiding chemotherapy based on individual progression.

95.4% of patients (255) in group B did not suffer a relapse 3 years later, and among those who managed to be treated without chemotherapy during the entire trial, close to 30%, that percentage rose to almost 99%.

Simple hysterectomy, a safe option in early cervical cancer

Also at the meeting of the american society of oncology ASCO 2023, advances in surgical treatments were presented, such as the hysterectomy simple, which can be a safe option that also reduces complications, for those patients with low-risk cervical cancer, which is in an early stage.

The simple one involves the removal of only the uterus, as opposed to radical hysterectomy which, in addition to the uterus, can also affect part of the vagina, ovaries, fallopian tubes and nearby lymph nodes.

This approach for early cases of cervical cancer allows for less impact on the quality of life of these patients in terms of pain or sexual activity, among other aspects, according to the international phase III clinical trial SHAPE, promoted by Canada.

no patient behind

Three pillars make up the mission of the American Society of Clinical Oncology (ASCO), the foremost in the industry: to end cancer through research, education and equitable care. Points shared by the rest of the oncology community, which intends not to leave any patient or country behind.

The annual ASCO congress in Chicago, which opens on Friday the 2nd and closes on Tuesday, considers it a “moral obligation” to overcome inequalities.

The Director of the US National Cancer Institute, Monica Bertagnollipointed out in the plenary session last Saturday that “there is nothing more tragic” than someone cannot be cured, not because there are no means to do so, but because they are not within their reach.

The Oncologist Miriam Mutebi, President-elect of the African Association for Cancer Research and Training (Aortic), highlighted in a presentation that 70% of cancer deaths occur in low- and middle-income countries. In addition, countries to which only 5% of the resources spent on cancer go.

This, coupled in certain countries with stigma and the use of alternative therapies, results in poor patient outcomes. The solution, in his words, involves a joint effort.

Part of that effort is Coalition for Access to Oncological Medicines (ATOM), an initiative launched in 2022 and which has gained some of the prominence in congress. It seeks to generate synergies, improve existing models through innovative mechanisms and involve people from different sectors to break down access barriers to these drugs.

“We have the knowledge. We must involve everyone. We still lack the commitment to achieve this goal,” Mutebi said.

Cancer is in fact one of the leading causes of death in the world, responsible for almost 10 million deaths in 2020, approximately one in six, according to the latest data from the World Health Organization. The most common are those of the breast and lung, followed by those of the colon and rectum and the prostate.

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