Researchers are investigating a way of treating certain cancer patients without the use of chemotherapy. A study from the Icahn School of Medicine at Mount Sinai used a combination of four targeted therapies, which showed promising results in patients with a certain type of metastatic breast cancer, without chemotherapy. Researcher Amy Tiersten, MD, told Newsweek that it showed the possibility of achieving "an incredibly high clinical benefit rate that is durable" for patients.
It used a "chemotherapy-free regimen, using all targeted therapies for metastatic breast cancer that is both HER2-positive and hormone receptor (HR) positive." HER2-positive breast cancer is a breast cancer containing a protein promoting the growth of cancer cells, and tends to be more aggressive than other types of breast cancer, according to a report from Mayo Clinic. HR-positive breast cancer requires estrogen or progesterone to grow, and can be treated by targeting those hormones, according to the Cleveland Clinic. In this study, researchers used anastrozole, palbociclib, trastuzumab and pertuzumab as a first-line treatment for patients with HR-positive and HER2-positive metastatic breast cancer.
This was a first-line treatment, combining endocrine therapy and drugs that target pathways that drive tumor growth—and researchers believe the results may allow patients to avoid chemotherapy as an initial treatment. Tiersten told Newsweek that the study is "part of an overall effort within breast medical oncology to de-escalate therapy by delivering less toxic therapy with the same or better efficacy." The trial enrolled patients with the breast cancer subtype, who had not undergone any previous treatment, across five clinical sites. It found that 97 percent of patients experienced clinical benefit during the first six months of treatment.
After a follow-up of 39 months, 93 percent of participants were still alive, and the median was nearly 25 months before disease progression. Some patients were also found to have experienced durable responses to the treatment, with one on the regimen for more than six years. However, this study was relatively small, and more research is required to confirm the findings in larger, randomized clinical trials.
In a statement to Medical Xpress, researcher Rima Patel, MD, said the challenge in treating this specific type of breast cancer amounts to "balancing effectiveness with quality of life." "Many patients, particularly older adults or those with other medical conditions, may not be ideal candidates for chemotherapy," she said. "A targeted regimen that can be given primarily through oral medication and subcutaneous injection could offer a more convenient option while reducing some of chemotherapy's burden." Chemotherapy can be difficult on the body, with side effects ranging from mild and treatable, to potentially causing serious complications, according to the Mayo Clinic. Common side effects include nausea, vomiting, hair loss, fever, sores, pain and bleeding, and in some cases can lead to kidney problems, infertility, heart problems, nerve damage and more.
Side effects of the new regimen were not unexpected when considering the four medications used, with the most common being neutropenia, low white blood cell counts, diarrhea and anemia. Just one patient discontinued the treatment due to side effects. According to the American Cancer Society, breast cancer is the most common cancer in women in the United States after skin cancer.
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