Among the most prevalent cancers in our country is breast cancer, the most prevalent form of cancer in the female sex, affecting 1 in every 9 women. Thanks to early detection and new treatments, however, about 87 percent of women who develop breast cancer recover from the disease.
With the chemotherapy treatment, we have seen a significant improvement, but despite this, chemotherapy is still seen as a type of treatment that causes much fear and apprehension in patients.
The Accuracy of Molecular Diagnostics
Today, we can assess the individual risk of each patient and, therefore, offer the best therapy to reduce the risk of recurrence. Thanks to genomic profiling, we can identify which patients diagnosed with breast cancer should receive precautionary chemotherapy and which patients can avoid this therapy instead.
Thanks to the profiling technique, we have observed a net reduction in the number of chemotherapies: About 50 percent of patients who were recommended chemotherapy in the past can now avoid it because advanced molecular diagnostics provide definite data about the expected benefit of chemotherapy, excluding aggressive treatments when their benefit is marginal or absent.
Breast Cancer Therapies
While chemotherapy continues to be an often necessary option, it is also true that it is not the only treatment available to an oncologist. Other anti-tumor therapies are known; sometimes, they are as efficient, if not more, than chemotherapy.
For example, endocrine therapy with anti-estrogen drugs is used for the so-called endocrine-sensitive tumor expressing estrogen/progesterone receptors. This therapy is sometimes combined with new biological drugs directed against molecular targets crucial for controlling tumor growth. It is the case of oral therapy with cyclin-dependent kinase 4/6 inhibitors – more commonly known as cyclin inhibitors.
There are also molecularly targeted oral therapies for breast cancer cases with mutation of particular critical genes, as in the case of BRCA1/2 gene mutation. In these cases, one can resort to exclusive biological treatment with PARP-inhibitor drugs, particularly effective in BRCA-mutated tumors.
Still, immunotherapy is often the first line of treatment, magnifying the anti-tumor action of the body’s immune system – thanks to immune checkpoint inhibitors – when faced with a so-called ‘immunogenic’ tumor in which immunologic engagement can be decisive.
We can thus recognize how, today, it is possible to personalize cancer treatment with precision, allowing the patient to derive the maximum benefit from it.
The Innovation of New Antibody-Drug Conjugates
Even chemotherapy itself, however, has experienced significant improvements in recent years, which over time have increased its therapeutic index and improved tolerability.
In particular, we are talking about antibody-drug conjugates (ADCs). Combining chemotherapy with monoclonal antibodies – directed against specific tumor proteins – allows for more precise targeting of chemotherapy treatment by increasing efficacy and reducing toxicity.
Therapy with the new antibody-drug conjugates combines the targeted action of the monoclonal antibody directed at the tumor and the cytotoxic action of the chemotherapy drug to which it binds, thus acting predominantly on the tumor tissue and partially preserving healthy tissue.
These new antibody-drug conjugates have demonstrated unprecedented efficacy and represent real hope for many patients, including cases of now advanced disease.
