New Trends in Oncology: De-Escalation of Breast Cancer Treatments
Colloquially, we usually speak of “treatment in less” to encompass new trends in oncology. In oncological medicine, specialists are now opting for less aggressive treatments for breast cancer patients, without compromising the final results. This individualized approach, known as “personalized treatments” or “targeted therapies,” was one of the central topics discussed at the Multidisciplinary Symposium on Breast Cancer held in Buenos Aires.
More than 500 specialists gathered at the symposium to share and debate the latest international research on breast cancer. The focus was on identifying patients who could benefit from a de-escalation of treatments, meaning using less aggressive treatment regimens without impacting the potential results.
Recent studies have shown promising results in de-escalating conventional treatments, especially in patients with clinically negative axilla. One notable finding was from the Sound study conducted in Italy, which included over 1,400 patients with small node-negative breast cancer who did not undergo axillary surgery. The study demonstrated similar five-year distant disease-free survival rates in patients who did not undergo axillary surgery compared to those who did.
In addition, recent research suggests that in certain cases, adjuvant chemotherapy may not be necessary for patients with small triple-negative tumors or tumors expressing the Her 2 Neu oncogene. This personalized treatment approach aims to provide effective treatment while minimizing unnecessary side effects.
The president of SAM, Francisco Terrier, highlighted the importance of risk-adapted treatment, emphasizing that the aggressiveness of therapies can be de-escalated, especially in surgical procedures. With the goal of increasing cure percentages while prioritizing patient quality of life, the trend towards “treatment in less” is becoming increasingly feasible in selected patients with biologically favorable tumors.
Immunotherapy is also gaining ground in breast cancer treatment, with promising results when used in conjunction with traditional chemotherapy. The synergy between the two treatments allows for lower doses of chemotherapy, reducing toxicity and improving overall outcomes.
Furthermore, the oncofertility advice provided to young patients with positive BRCA genetic mutations is essential for future family planning. Recent research has shown that pregnancy after breast cancer treatment can be safe in these patients, challenging the belief that it was a risk factor.
Overall, the shift towards de-escalating breast cancer treatments while maintaining efficacy is a promising trend in oncology. By individualizing treatment approaches and incorporating the latest research findings, oncologists are paving the way for more personalized and effective breast cancer care.