Advanced Treatment Options for Breast Cancer Patients

Advances in treatment options for breast cancer patients mean that more women are surviving the disease and those diagnosed with incurable breast cancer are living longer.

Advanced treatment options also take into consideration recovering a patient’s quality of life, rather than focusing only on a cure.

These advances are giving hope, with scientific research resulting in many promising developments in breast cancer treatment, which will improve and save the lives of many women in the future.

In this article, we summarize some of the complex and exciting advances in breast cancer treatment which are available at Cleveland Clinic Abu Dhabi’s Breast Health & Cancer Program.

Targeted Therapies

Targeted therapy is a cancer treatment which uses drugs to target the specific genes and proteins which help cancer cells to live, grow and spread. In recent years, the availability of new targeted therapies for breast cancer have offered hope to many women. There is ongoing research in this exciting area and many more targeted therapies are currently being studied in trials.

Initially, hormonal targeted therapies were approved for breast cancer. It was then discovered that around 20 - 25% of breast cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2), which makes tumor cells grow. This is called HER2-positive breast cancer, a subtype of breast cancer which for many years was associated with poor outcomes and higher mortality rates.

However, the development of HER2-targeted therapies has significantly changed the treatment paradigm of patients with HER2-positive breast cancer. HER2-targeted therapy is suitable only for certain types of breast cancer, and the drug given will depend on the stage of the cancer, and many other factors. It may be given in combination with chemotherapy.

Immunotherapy

Immunotherapy for cancer patients represents one of the most significant advances in oncology in recent years. Using the power of the body’s immune system to attack cancer cells, the treatment offers effective anti-tumor activity for a number of types of breast cancer.

For many years, breast cancer was thought to be immunologically silent. However, recent breakthroughs have shown that substances called immune checkpoint inhibitors can be effective in some metastatic breast cancers.

Checkpoint inhibitors are an immunotherapy that blocks proteins which stop the immune system from attacking cancer cells. There are different drugs which block different checkpoint proteins. Checkpoint inhibitors that block a protein called PD-L1

(a protein on T cells in the immune system which usually help to keep them from attacking other cells in the body) boost the immune response against breast cancer cells and can shrink tumors.

This type of treatment is suitable mostly for women with triple-negative breast cancer and may be used in combination with chemotherapy.

PARP Inhibitors

PARP (Poly-ADP Ribose Polymerase) inhibitors are a type of targeted therapy. PARP is a protein which is found in our cells and helps damaged cells to repair themselves. PARP inhibitors work by stopping the PARP from doing this repairing function in cancer cells, causing them to die.

Research has focused on the effectiveness of PARP inhibitors in cancers in which there is already a problem with cell damage repair, such as cancers with a mutated BRCA gene.

Cancer cells with BRCA gene faults have a poor repair system already and by blocking PARP with PARP inhibitor drugs, the cells are not able to repair themselves, causing them to die.

Most inherited breast cancers are associated with BRCA mutations. PARP inhibitors can be used in the treatment of breast cancer which is HER2 negative with an altered BRCA gene.

Ethos Adaptive Radiotherapy

Ethos adaptive radiotherapy is an advanced, innovative cancer treatment which transforms cancer care and is improving outcomes for patients with certain types of breast cancer.

Ethos adaptive radiotherapy combines state-of-the-art imaging technology with advanced radiation therapy techniques.

Powerful artificial intelligence and real-time imaging allow the radiation dose that is being delivered to be adjusted during treatment, based on the patient’s unique needs. Their anatomy and physiology are considered, which ensures a very precise delivery of radiation, minimizing damage to healthy surrounding tissues.

Learn more about Ethos Radiation here

Scalp Cooling

Scalp cooling systems are an option for patients undergoing chemotherapy to help them keep some or quite a bit of their hair. The system is an example of emerging technology which is prioritizing and taking patient quality of life into consideration.

Scalp cooling systems are helmet-like hats that are worn during chemotherapy. They fit tightly to the head and are filled with a cold liquid. The cold causes a narrowing of the blood vessels on the scalp, which can reduce the amount of chemotherapy which reaches the hair follicles. Because less medicine is in the follicles, hair is less likely to fall out.

The cold also decreases the metabolic activity of hair follicles, making cells divide more slowly, protecting them from the chemotherapy.

Hand Cooling and Compression

Hand cooling and compression therapy can help to prevent neuropathy in patients receiving chemotherapy, enhancing quality of life and treatment outcomes. Neuropathy is a general term that refers to numbness, pain or tingling that is felt when the peripheral nerves have been damaged. Certain types of chemotherapy drugs, called taxanes, can induce neuropathy.