Breast cancer, targeted therapy reduces the risk of metastasis

A major shift in the treatment of early breast cancer IS EXPECTED. In fact, the news comes from ESMO’s Virtual Plenary that a “targeted” drug, abemaciclib, is able to significantly reduce the risk of relapses – in particular of distant ones, that is metastases – in patients with breast cancer. more common and at high risk of relapse. It is the first CDK 4/6 protein inhibitor to be more effective than standard therapy in early stage cases. This is demonstrated by the latest results of the monarchE study: after an observation period of over two years, abemaciclib reduced the risk of relapses by more than 30% compared to standard hormone therapy alone. In particular, three-year metastasis-free survival was over 90% in patients (and in patients, as breast cancer also affects men) treated with abemaciclib and about 86% in the control group. , with an absolute improvement of 4.2%: to date 565 metastases have been observed, of which 232 in the group of patients treated with abemaciclib and 333 among the controls.

These results have just been published in Annals of Oncology and the US drug agency, the FDA, has already approved the therapy with the new indication: in the US, abemaciclib may be prescribed for patients with early hormone-type breast cancer. -sensitive (HR + and HER2-) with a high risk of relapse. “The new results confirm the clinical benefit of the combination of abemaciclib and hormone therapy at a longer observation time – explains Valentina Guarneri, Full Professor of Medical Oncology and Director of the Oncology 2 Complex Operational Unit at the Veneto Oncology Institute (Iov):” The fact that it mainly reduces remote recurrences makes the data even more solid. The aspect of toxicity is not secondary: with almost 90% of patients who have finished the treatment, this analysis confirms the safety profile “.

The first novelty for early “hormonal” cancer since the 2000s

CDK 4/6 protein inhibitors are a class of targeted drugs – palbociclib, ribociclib and abemaciclib – that have already profoundly changed the treatment of hormone-sensitive advanced breast cancer, and clinical trials have been conducted for some time to see if they can be effective. also as adjuvant therapy, to prevent the onset of metastases or delay their onset after surgery. “It was since the early 2000s, when aromatase inhibitors were introduced, that we had not seen substantial clinical improvements in adjuvant therapy for hormone receptor positive breast cancer, the most frequently diagnosed type of breast cancer,” explains 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 cases of breast cancer are cases with positive hormone receptors, therefore progress in this subtype of tumor have a particular relevance. The results of the monarchE clinical trial are of extreme clinical relevance both for the extent of the benefit and because this benefit concerns patients at higher risk of relapse after surgery. We will have one more important weapon to use against high-risk breast cancer “, continues Del Mastro:” The drug has just been approved by the FDA in the United States for the adjuvant treatment of high-risk women and we hope it will be available soon. Also in Italy”.

The new Esmo guidelines

Also these days is the news of the new guidelines for the treatment of breast cancer from the European Society of Medical Oncology (Esmo), also just published in Annals of Oncology. They were developed by a group of 28 experts and the first signatures are by the Italian Alessandra Gennari of the University of Eastern Piedmont, in Novara, and by Nadia Harbeck of the University of Munich. “These are global guidelines that have seen the participation of leading breast cancer experts from around the world, including the US and Australia, who have put the patient at the center and who have followed the highest methodological levels of evidence”, Gennari says: “The latest innovations, such as those on agnostic drugs, have also been taken into consideration, considering all the alternative options possible in the event that some drugs are not available in all countries. In essence, a patient anywhere in the world can receive the best treatments for what are the regulatory provisions and the availability of care. This – concludes Gennari – is a great innovation compared to the previous guidelines “.