Breast cancer treatment is continuously evolving and provides improved treatment outcomes.
Advanced breast cancer treatment options are more targeted and can alter the course of breast cancer along with the betterment of the quality of life.
The new treatment options also open the door to treating advanced stages of breast cancer with great improvement of survival rate.
Following are some of the new breast cancer therapies:
Pembrolizumab
The mechanism of action of pembrolizumab is to help the immune system to attack cancerous growth.
The FDA has recently approved pembrolizumab for treating early-stage triple-negative breast cancer after analyzing detailed research.
Pembrolizumab is also approved in combination with chemotherapy for first-line treatment in patients whose cancers have the protein PD-L1 present.
Trodelvy
In 2020, Trodelvy was approved by the FDA.
This new invention can be used to treat metastatic triple-negative breast cancer that hasn’t reacted to at least two other cancer medications.
Breast cancer is considered triple-negative depending upon three factors including the absence of estrogen or progesterone receptors, and also does not contain HER2 (an extra protein).
The metastatic triple-negative breast cancer is difficult to treat because of its quick spreading ability compared with other types.
Trodelvy is an antibody-drug conjugate that is different from conventional chemotherapeutic medicine.
Trodelvy directs the chemotherapy drug to attack the cancer cell only.
Thus, the healthy tissues are least affected by chemotherapy.
Enhertu
FDA had approved Enhertu in December 2019.
This medicine is effective to treat HER2-positive breast cancer.
Enhertu is unable to remove through surgery because of its metastatic nature.
Enhertu has three components:
- fam-trastuzumab, an anti-HER2 medication.
- DXd, a topoisomerase I inhibitor that halts cancer cells proliferation.
- a compound that associates the molecules of the other components.
Enhertu is only for adults who have had at least two other treatments for HER2-positive breast cancer but not responding and the metastatic nature of cancer is unable to remove through surgery.
Nerlynx
In 2017, Nerlynx had approved by the FDA for early-stage breast cancer.
But in 2020, FDA also approved this drug for metastatic cancer in combination with the chemotherapy drug capecitabine.
Nerlynx is only for adults who have had at least two other treatments for HER2-positive breast cancer but have not responded.
Nerlynx is a tyrosine kinase inhibitor that stops abnormal cells proliferation in HER2-positive breast cancer cells.
Tukysa
In 2020, the FDA approved Tukysa that has been used in combination with the chemotherapy drugs trastuzumab and capecitabine.
Tukysa is only for adults who have advanced metastatic HER2-positive breast cancer which is difficult to treat as it spreads to the brain.
This drug is a tyrosine kinase inhibitor. It blocks an area of the HER2 gene in cancer cells, stopping the cells from growing and spreading.
Phesgo
Phesgo is a combination injection made up of pertuzumab, trastuzumab, and hyaluronidase-zzxf. The FDA has approved this medication in 2020.
Phesgo works by binding to HER2 sites and stopping cancer cell growth.
A cancer patient can administer this drug with the help of a health professional at their home only.
Phesgo is only for adults who have early or advanced metastatic HER2-positive breast cancer.
Alpelisib
Alpelisib was approved by the FDA in 2019.
In combination with fulvestrant, Alpelisib is recommended for postmenopausal people with hormone receptor-positive, HER2-negative advanced, or metastatic breast cancer.
Alpelisib is acting as an inhibitor of phosphatidylinositol 3-kinase (PI3K).
It stops tumor cells growth.
Alpelisib is recommended only for people with PIK3CA gene mutations.
Therefore, the patient must first take an FDA-approved diagnostic test to find out whether the patient has the specific mutation.
Talazoparib
The FDA approved talazoparib in 2018 for treating locally advanced or metastatic HER2-negative breast cancer people with a BRCA1 or BRCA2 mutation.
Talazoparib is an oral pill formulation.
Talazoparib is a PARP inhibitor and works by making it harder for cancer cells to survive DNA damage.
Biosimilars
Following are some of the recently approved biosimilars to Herceptin for breast cancer:
- Herzuma (trastuzumab-pkrb)
- Kanjinti (trastuzumab-anns)
- Ogivri (trastuzumab-dkst)
- Ontruzant (trastuzumab-dttb)
- Trazimera (trastuzumab-qyyp)
Emerging and breakthrough therapies
Pelareorep therapy
Pelareorep is an immuno-oncolytic virus drug that destroys cancer cells.
This drug is more effective in combination with other chemotherapy drugs like paclitaxel and avelumab for treating local or metastasized HER2-negative breast cancer.
Histone deacetylase (HDAC) inhibitors
HDAC inhibitors can block HDAC enzymes that are present in the cancer growth pathway.
Tucidinostat is one of the examples of HDAC inhibitors.
Phase 3 clinical trial of this class of drugs is ongoing for confirming its efficacy against advanced hormone receptor-positive breast cancer.
Tucidinostat has shown promising results so far in other trial phases.
Cancer vaccines
Vaccines activate the immune system to act against cancer cells.
Specific tumor cells containing vaccines help the immune system better recognition of cancer cells and destroy them.
Currently, many cancer vaccines are in the pipeline.
Ongoing researches are checking the efficacy and safety of these vaccines.
In 2018, preliminary data stated that a HER2-targeted therapeutic cancer vaccine demonstrated clinical benefit in people with metastatic HER2-positive cancers.
The Mayo Clinic is also studying an anticancer vaccine that targets HER2-positive breast cancer.
The vaccine is intended to be used in combination with trastuzumab following surgery.
Combination therapies
In recent days, multiple clinical trials are being conducted for breast cancer.
Many of these trials are assessing combination therapies of several already approved treatments.
Researchers assume that using a combination of one or more targeted therapies can improve the treatment outcome.
