A ‘landmark’ drug that buys time for women by halting advanced breast cancer could benefit around 8,000 women in the UK each year.
In a trial of more than 700 people, the drug shrank the tumors of nearly a quarter of those who received it, doubling the time for the cancer to progress.
Those who took the drug, called capivasertib, in addition to hormone therapy had an average of just over seven months with no progression or worsening of their cancer.
That compared to just over three and a half months for people on the current standard treatment of hormone therapy alone.
In a trial of more than 700 people, the drug shrank the tumors of nearly a quarter of those who received it, doubling the time before the cancer progressed
Breast cancer patient, 65, says drug is ‘great’
Linda Kelly, 65, from Milton Keynes, joined the trial at the Royal Marsden in August 2021 after her breast cancer had spread to her bones and chest wall.
She said: ‘The results are amazing.
“My disease has reduced significantly, my cancer has not progressed, and I have not had any new tumors.
“The treatment is much less grueling than chemotherapy and I’ve gotten a longer life.”
The drug could be a lifeline for women with breast cancer that has spread or traveled to different parts of the body, such as the liver or brain, and who have run out of other NHS treatments apart from grueling chemotherapy.
A British member of the Capivasertib trial, 65-year-old Linda Kelly, said the drug had given her the confidence to “live life to the fullest” and marry her partner of 20 years.
Capivasertib, taken as a tablet twice a day four days a week, belongs to an entirely new class of drugs that work differently from existing breast cancer therapies by turning off a cellular “switch” that stimulates cancer growth.
According to British researchers, it is a new line of attack and the first of this type of drug to be found to be so effective in a major study.
They say the results are strong enough to now submit them to the regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).
If approved by the regulator and then the drug watchdog of the National Institute for Health and Care Excellence, the new drug could be available on the NHS in the near future.
They hope that in the future the drug could help women who are newly diagnosed with breast cancer — about 70 percent of them have the type of breast cancer targeted by the study, known as estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER-) negative. breast cancer.
Nick Turner, Professor of Molecular Oncology at the Institute of Cancer Research (ICR) in London, who led the global trial of Capivasertib, including patients from the Royal Marsden, where he is an oncologist consultant, said: ‘This is a fantastic finding for patients with breast cancer.
“Even with the best current treatments, people with this type of advanced breast cancer will eventually see their cancer stop responding to treatment and it will get worse.
“We are excited that this potential first-in-class drug in combination with hormone therapy can reduce the progression of these advanced cancers and shrink tumors in nearly a third of cases.
“We believe this new treatment could enable more women and men to live well and live longer with breast cancer.”
Professor Kristian Helin, Chief Executive Officer of the ICR, said: ‘This is a milestone for the treatment of advanced forms of the most common type of breast cancer.
‘Capivasertib could offer an entirely new treatment option for these patients.
‘This is a great success story for British science.’
Women with the most common form of breast cancer, ER-positive, HER2-negative breast cancer, rely on hormone therapy to block estrogen in their bodies that fuels the cancer.
This allows them to live months or years longer, but many women eventually find that the treatment is no longer working as their cancer becomes resistant to the tablets.
Many women in the trial could no longer use hormone pills for that reason.
Capivasertib is an answer to this problem because it targets an entirely different way cancer grows and spreads – by turning off a “switch” called AKT that allows cancer cells to divide rapidly.
The trial gave 355 people the drug, while 353 were given dummy pills instead.
All of the cancer patients in the study also received fulvestrant – a hormone therapy used after people become resistant to anastrazole, but which on its own doesn’t work well for many women.
The results showed that patients receiving capivasertib and fulvestrant had no progression of their cancer for an average of 7.2 months, compared to 3.6 months for patients treated with dummy pills and fulvestrant.
The treatment shrank tumors in 23 percent of patients, compared with 12 percent of patients who didn’t get it.
Longer follow-up is needed to see if the drug also extends the lives of women with advanced breast cancer.
But there is great hope from the findings, presented at the San Antonio Breast Cancer Symposium this week.
Trials of capivasertib are currently underway for other types of cancer, including prostate cancer.
Professor Helin said: ‘The existing findings are already strong enough to submit capivasertib to regulators to be considered for approval as a new breast cancer treatment.’
All of the women and men in the trial of capivasertib, which is manufactured by the pharmaceutical company AstraZeneca, had their cancer return or progress on standard hormone treatments.
The majority had also previously been treated with CDK4/6 inhibitors – drugs that block the multiplication of cancer cells – but the cancer came back or got worse.
The patients would normally be offered fulvestrant hormone therapy, but because it is often ineffective, many would be left with only the option of chemotherapy.
The development of capivasertib followed years of basic research at ICR aimed at understanding the precise structure of the AKT switch.
The most common side effects of the drug were rash and diarrhea.
Dr. Kotryna Temcinaite, senior research communications manager at Breast Cancer Now, said: ‘Understanding how to control incurable breast cancer when it no longer responds to existing treatments is key to helping more people live longer with the disease.
“These encouraging results suggest a new way to treat patients with advanced ER-positive HER2-negative breast cancer, giving them valuable extra time with their loved ones before the disease progresses.
“We hope that people can benefit from this treatment combination as soon as possible.”
Breast cancer is one of the most common cancers in the world, affecting more than two MILLION women each year
Breast cancer is one of the most common cancers in the world. Each year there are more than 55,000 new cases in the UK and the disease claims the lives of 11,500 women. In the US, it affects 266,000 people and kills 40,000 each year. But what causes it and how can it be treated?
What is breast cancer?
Breast cancer arises from a cancer cell that develops in the lining of a duct or lobule in one of the breasts.
When the breast cancer has spread to the surrounding breast tissue, it is called an ‘invasive’ breast cancer. Some people are diagnosed with “carcinoma in situ,” where no cancer cells have grown beyond the duct or lobule.
Most cases develop in women over the age of 50, but younger women are sometimes affected. Breast cancer can develop in men, although this is rare.
Staging means how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.
The cancer cells are graded from low, which means slow growth, to high, which means fast growth. High-grade cancers are more likely to come back after being treated first.
What Causes Breast Cancer?
A cancerous tumor starts with one abnormal cell. The exact reason why a cell becomes cancerous is unclear. Something is thought to damage or alter certain genes in the cell. This makes the cell abnormal and multiply ‘out of control’.
Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance of developing breast cancer, such as heredity.
What Are the Symptoms of Breast Cancer?
The usual first symptom is a painless breast lump, although most breast lumps are not cancerous and are fluid-filled cysts, which are benign.
The first place where breast cancer usually spreads is the lymph nodes in the armpit. When this happens, you get a swelling or lump in an armpit.
How is breast cancer diagnosed?
- Initial assessment: A doctor examines the breasts and armpits. They may perform tests such as a mammogram, a special X-ray of the breast tissue that can indicate the possibility of tumors.
- Biopsy: A biopsy is when a small sample of tissue is removed from an area of the body. The sample is then examined under the microscope to look for abnormal cells. The sample can confirm or rule out cancer.
If you are confirmed to have breast cancer, further tests may be needed to assess whether it has spread. For example, blood tests, an ultrasound of the liver or a chest x-ray.
How is breast cancer treated?
Treatment options that may be considered include surgery, chemotherapy, radiotherapy, and hormone treatment. Often a combination of two or more of these treatments is used.
- Surgery: Breast-conserving surgery or removing the affected breast, depending on the size of the tumor.
- Radiotherapy: A treatment that uses high-energy beams of radiation aimed at cancerous tissue. This kills cancer cells or stops cancer cells from multiplying. It is mainly used in addition to surgery.
- Chemotherapy: A treatment for cancer using anticancer drugs that kill cancer cells or prevent them from multiplying
- Hormone treatments: Some types of breast cancer are affected by the “female” hormone estrogen, which can stimulate cancer cells to divide and multiply. Treatments that lower the level of these hormones or prevent them from working are often used in people with breast cancer.
How successful is the treatment?
The outlook is best in those who are diagnosed when the cancer is still small and has not spread. Surgical removal of a tumor at an early stage can then give a good chance of a cure.
Routine mammography offered to women between the ages of 50 and 70 means that more breast cancers are diagnosed and treated at an early stage.
For more information visit breastcancernow.org or call the toll-free helpline on 0808 800 6000