A blood test, liquid biopsy, could reveal in as little as 15 days – and without the need to wait for a follow-up CT scan – whether the cancer treatment for women with metastatic breast cancer is working or not, and that’s through observation. of the trend of two biomarkers, or two elements characterizing the neoplasm. This is the scenario that could become possible for women with Her2 negative hormone-sensitive metastatic breast cancer in treatment with the indicated and most effective therapy (ribociclib in combination with letrozole hormone therapy). This form of neoplasm is the most widespread and affects about 60-70% of metastatic patients. In Italy it affects 7-8 thousand women every year.
The preliminary result comes from a study conducted entirely in Italy (BioItaLEE), which will be presented at the Congress of the American Society of Clinical Oncology (ASCO) which opens today in Chicago. The study involved 287 patients from 47 Italian centers. It is a precision medicine study that “identifies specific information in the blood – explains the research manager Michelino De Laurentiis, director of the Department of Breast and Thoracic-Pulmonary Oncology at the Pascale Institute in Naples – or traces of tumor DNA circulating and a biochemical parameter (tyrosinokinase A) “. All the patients involved, candidates for standard therapy, underwent a blood sample before starting the treatment, then repeated on the 15th day of therapy. By measuring the presence of the two biomarkers, explains De Laurentiis, “on the 15th day we realized that we were already able to divide the patients between those highly responsive to therapy and those poorly responding”. An extremely significant step forward: “The advantage, if these data are confirmed, is first of all that the treatment will no longer be carried out for a few months and then do the control scan to understand the outcome, but already after 15 days it will be possible to evaluate whether the therapy works and if it doesn’t, the patients can be immediately referred to an alternative treatment “. In this way, the patient “can also be spared toxicity and unnecessary side effects. If the data were confirmed, with the liquid biopsy we could therefore know in advance which tumors are resistant to treatment”. And the advantage is also for the health system, since the method is non-invasive and low-cost. Now, underlines De Laurentis, “we will focus on patients found to be resistant to standard care, to understand if there are particular mutations, in order to then be able to personalize the therapy precisely on the basis of the patient’s resistance mechanisms. a precision oncology “. This work, “all Italian, is enjoying great international interest – explains Saverio Cinieri, president of the Italian Association of Medical Oncology (Aiom) -.
It defines a research model that is placed in precision oncology and opens up important prospects for chronicizing metastatic disease “. Currently,” we are faced with preliminary data – concludes Grazia Arpino, professor of Medical Oncology at the Federico II University of Naples, presenting the study at the ASCO Congress – and more clinical trials are needed. However, their usefulness could be crucial. “In 2020, about 55,000 new cases of breast cancer were estimated in Italy. More than 37,000 women are now living with the metastatic disease.
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