Major Advances in 2012
There are always all kinds of published lists at the end of the year: Top Five Ice Cream Flavors, Ten Funniest VIdeos, etc. This is a more serious one that feels important and relevant for us. ASCO (the American Society of Clinical Oncology) just released a long report about research and clinical advances in 2012. Their purview is all of cancer, so much of the report is not breast cancer specific. If you have been reading this blog for any length of time, however, you are aware that the direction of cancer research is away from specific diseases and towards specific genetics/cell types. Not surprisingly, it turns out that cancers that begin in different parts of the body and are named by their primary site (liver cancer, prostate cancer, breast cancer) have lots of things in common, and the discovery of targeted therapies makes those similarities valuable.
This summary of ASCO's long article is from MedScape. If you have time and inclination, you can also go to ASCO's website (www.ASCO.org) and read the whole thing. Note that the second included (in this excerpt) advance is Tykerb for metastatic her2 positive breast cancer. I personally know three women whose cancer has seemingly vanished with this treatment. Will it return? Almost certainly, yes, but this is a terrific achievement and hopeful for all of us.This is the beginning of the shorter article and then a link to read more:
A list of 17 major advances in clinical cancer research, considered to be practice-changing, has been issued by the American Society of Clinical Oncology (ASCO) in its annual report, entitled Clinical Cancer Advances 2012.
The report, which covers the period from October 2011 to September 2012, also highlights 70 "notable advances" that are promising but not immediately applicable to practice.
"Consistent, significant achievements are being made in oncology care with novel therapeutics, even in malignancies that have previously had few treatment options, as well as in defining factors that will predict response to treatment. ASCO's report distils the most significant of these advances that [will affect] the lives of cancer patients today," said Bruce Roth, MD, coexecutive editor of the report.
The 17 major advances considered to be practice-changing are listed below; the top 5 were identified as such by ACSO; the others follow in no particular order.
Everolimus ( Afinitor) in hormone-receptor positive breast cancer. Everolimus, an mTOR inhibitor used in the treatment of renal cell cancer, was approved for use in combination with exemestane ( Aromasin) for women with hormone-positive breast cancer that has spread despite initial treatment with an aromatase inhibitor. This indication was based on results from the 724-patient BOLERO-2 trial, which was halted early because of the benefit observed. The combination of everolimus plus exemestane increased the median time to disease progression to 10.6 months, compared with 4.1 months with exemestane alone ( N Engl J Med. 2012;366:520-529).
T-DM1 in HER2-positive metastatic breast cancer. T-DM1, which is currently awaiting approval by the US Food and Drug Administration (FDA), consists of the anti- HER2 antibody trastuzumab ( Herceptin) linked to the cytotoxic emansine. "We've taught an old friend a new trick — we're using [trastuzumab] as a delivery vehicle," said one expert. In the pivotal EMILIA trial of 991 women with HER2-positive metastatic breast cancer who had stopped responding to trastuzumab, T-DM1 improved survival, compared with the current standard treatment of capecitabine ( Xeloda) and lapatinib ( Tykerb) ( N Engl J Med. 2012;367:1783-1791). After 2 years, the median survival rates were 65.4% with T-DM1 and 47.5% with the standard combination.