Cancer; Women's Health
Recent advances in breast cancer treatment
September 24, 2019
Advances in breast cancer care
A UT Southwestern expert offers insight into the latest treatment options – and what they might mean for patients.
With treatments like antiestrogens, chemotherapy, targeted therapies, and immunotherapies, and improved radiotherapy approaches like the GammaPod, there are more options for patients with breast cancer than ever before.
Sangeetha Reddy, M.D., Assistant Professor in the Department of Internal Medicine at UT Southwestern Medical Center, shares how targeted therapies, immunotherapies, and other advances in care are helping breast cancer patients live healthier, longer lives.
“Breast cancer is only beginning to see some of these benefits compared to some of the other solid tumors, but we are seeing a subset of breast cancer patients living longer due to these immunotherapies. There are many exciting clinical trials that are looking at expanding these benefits to more breast cancer patients."
Q. How have treatment options in breast cancer improved in recent years?
Dr. Reddy: First of all, there are a lot more options now, and many of them are more sophisticated than before. Previously, we would treat many patients with chemotherapy drugs that non-specifically kill any rapidly dividing cells in the body, which include cancer cells but also some normal cells, resulting in a lot of side effects. Now we have identified the specific abnormal proteins or pathways in a patient’s cancer cell that help cancer cells grow, and we can block that growth with focused targeted therapies that are highly effective but have less toxicity.
Another breakthrough in cancer care has been the rapid progress being made in cancer immunotherapy. Immunotherapy uses the patient’s immune system to attack the cancer, the way it would a virus or other infection. It turns out that the patient’s own immune system, when deployed against the cancer, may be a powerful alternative or complementary approach to current chemotherapies or targeted therapies. Tumors that are metastatic and generally felt to be incurable or shorten life spans have now responded to immunotherapy, with some patients almost behaving as if they have cures and long-term responses, which was almost completely unheard of and is incredibly promising.
Breast cancer is only beginning to see some of these benefits compared to some of the other solid tumors, but we are seeing a subset of breast cancer patients living longer due to these immunotherapies. There are many exciting clinical trials that are looking at expanding these benefits to more breast cancer patients.
Q. How have breast cancer treatments become more personalized?
Dr. Reddy: Doctors are not just looking for new ways to fight cancer, but to tailor different therapies to each patient’s tumor. It’s identifying the specific treatments that may help their cancer, figuring out how much treatment each patient needs, and reassessing this over the course of their treatment to provide the most personalized cancer care.
Doctors can analyze a patient’s tumor tissue to identify the specific tumor pathways that are abnormal or the status of a patient’s anti-tumor immune response. We now offer tumor profiling for many cancers to guide us on what treatments are likely to help or not help a patient. In doing so we are offering more effective targeted therapies, immunotherapies, and chemotherapies to those who would benefit the most from it, while sparing many patients from overtreatment. We are adjusting standards based on each patient.
The same advances are being made not just with systemic treatments like chemotherapy, targeted therapy, and immunotherapy, but also with radiation therapy. For example, the GammaPod cuts the standard four- to six-week radiation treatment to just one to five days for select patients. The device offers more precise treatments for breast cancer, delivering higher doses of radiation to a narrowly targeted area. UT Southwestern is the first center in Texas and only the second center in the world to offer GammaPod as a treatment option.
Q. Where do clinical trials fit in?
Dr. Reddy: We believe in providing our patients with a high-quality standard of care in fighting cancer, but in many aspects, we can do better. While providing the best possible level of care, clinical trials can help doctors find the best approach to fighting a specific type of cancer and unlock new ways to treat even the most aggressive forms.
Treatment as part of a clinical trial helps patients while contributing to the research community, ultimately helping patients as a whole. Whether someone might need more aggressive or less aggressive treatment, either way, clinical trials elevate the quality of cancer care and patient outcomes. I am developing a breast cancer immunotherapy program for our patients, while other breast cancer physicians at UT Southwestern are tackling other important aspects of breast cancer care to provide the very best treatment options for each patient.