Survival rates for early stage or localised breast cancer are high, thanks to improved detection and treatment. But once breast cancer has spread to other parts of the body, the focus moves to urgently stopping the cancer from growing any further and adding priceless months or years to a patientās life.
Now, an international study, including Australian patients, has shown that a new combination of medication gives patients with an aggressive type of metastatic breast cancer more than a year of extra time before their cancer progresses.
The new treatment regime promises to benefit up to 10% of people with metastatic breast cancer, says senior medical oncologist Professor Elgene Lim, who led the Australian arm of the study.
Researchers examined whether the drug palbociclib, which blocks proteins that promote the division of cancer cells, can delay cancer growth in people with metastatic breast cancer that is both hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER-2) positive.
The PATINA trial was conducted by Breast Cancer Trials and involved 496 participants, including 49 patients from Australia and New Zealand.
Results presented at the San Antonio Breast Cancer Symposium showed that adding the palbociclib inhibitor to a patientās standard drug therapy extended their progression-free survival for an average of 15 months.
Professor Lim said that difference was clinically significant. āThat means patients stay, on average, 15 months longer on this treatment before the cancer progresses and they need to change therapies,ā he said.
Professor Lim said the new treatment regime could change clinical practice and become the new standard of care. However, the drug is not yet funded through the Pharmaceutical Benefits Scheme.
Metastatic HR-positive, HER-2-positive breast cancer has traditionally been treated with three therapies: the anti-HER2 medications trastuzumab and pertuzumab, plus endocrine therapy. In the PATINA study, half the patients received the traditional gold standard treatment plan, while half were also given palbociclib, which blocks proteins that promote the division of cancer cells.
The research found that patients who took palbociclib plus a combination of anti-HER2 treatment and endocrine therapy did not experience any growth in their cancer for an average of 44.3 months, compared with 29.1 months among patients who did not take palbociclib.
The quadruple therapy was also well tolerated, with only 7.5% of patients discontinuing treatment due to side effects. āThe vast majority were able to continue the therapy, and the side effects were manageable,ā Professor Lim said. The incidence of adverse events was similar in both patient groups.
Professor Lim said patients with HR positive, HER-2 positive breast cancer account for 7.5% to 10% of all breast cancer patients. āThere is a significant minority of breast cancer patients who will benefit from this therapy,ā he said.
Publication
Patina – ANZ 1701/AFT-38: PATINA. Metzger O, Mandrekar S, DeMichele A, Gianni L, Gligorov J, Lim E, Ciruelos E, Loibl S, Dockter T, Gonzalez Farre X, Francis P, Lynce F, Lanzillotti J, DuFrane C, Drop I, Vaz-Luis I, Valagussa P, Tripathy D, Soi S, Prat A, Goetz M, Escriva-de-Romani S, Porter D, Spoenlein J, Saresai S, Heudel P, Koehler M, Huang Bartlett C, Hoynskyj A, Copalakrishna P, Gauthier E, Liu Y, Slaloge S, Miller K, Winer E, Partridge A, Goel S, Carey L. AFT-38 PATINA: A Randomized, Open Label, Phase III Trial to Evaluate the Efficacy and Safety of Palbociclib + Anti-HER2 Therapy + Endocrine Therapy vs. Anti-HER2 Therapy + Endocrine Therapy after Induction Treatment for Hormone Receptor-Positive (HR+)/HER2-Positive Metastatic Breast Cancer. SABCS 2024.Ā https://www.breastcancertrials.org.au/media-releases/patina-study-results/
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