Revolution in Breast Cancer Treatment Targets Tumor Mechanisms
Translated & summarized from Maariv by baba
A revolution in breast cancer treatment is underway, focusing on the specific biological mechanisms of individual tumors rather than just the general diagnosis. Professor Amir Sonnenblick highlighted that molecular and liquid biopsies identify genetic mutations, like in the PIK3CA gene, enabling personalized therapies. New studies show targeted treatments inhibiting the PI3K pathway improve outcomes for certain advanced breast cancer patients. This approach aims to select the correct treatment for the right patient at the right time.
The story in 5 lines · by baba
- Breast cancer treatment is shifting to target specific tumor mechanisms, not just the general diagnosis.
- Molecular and liquid biopsies identify genetic mutations for personalized treatment strategies.
- PIK3CA gene mutations are significant in advanced hormone receptor-positive, HER2-negative breast cancer.
- Targeted therapies inhibiting the PI3K pathway show improved outcomes in new studies.
- Personalized medicine aims to match the right treatment to the right patient at the right time.
A new approach to treating breast cancer is shifting focus from the general diagnosis to the specific biological mechanisms driving individual tumors. Professor Amir Sonnenblick of the Oncology Department at Tel Aviv Medical Center explained that while traditional diagnostic questions about tumor location, size, spread, hormone sensitivity, and HER2 protein expression remain important, they no longer tell the whole story. Today, doctors aim to understand what causes a specific tumor to grow and how to attack its driving mechanisms.
Two women with the same breast cancer diagnosis, such as hormone receptor-positive and HER2-negative, can have biologically different tumors. One might respond to anti-hormonal therapy while another develops resistance, or one may have a treatable mutation while the other does not. Therefore, beyond the general type of breast cancer, doctors now examine the tumor's unique biological fingerprint.
Molecular tests, including those on tumor tissue or via liquid biopsies (blood samples), are used to identify genetic changes with therapeutic implications. The goal is not just to perform tests because the technology exists, but to find information that can alter treatment decisions. For instance, a mutation in the PIK3CA gene, which overactivates the PI3K pathway crucial for cell division and survival, can be significant in advanced hormone receptor-positive, HER2-negative breast cancer. Specific drugs can be particularly effective against tumors with this mutation.
New studies show that for women with advanced or metastatic hormone-positive breast cancer carrying a PI3K pathway mutation, adding a targeted therapy that inhibits this pathway has improved treatment outcomes, especially if their disease progressed during or after anti-hormonal therapy. This highlights the potential of personalized medicine, tailoring treatments to a tumor's specific biological characteristics.
Liquid biopsies, analyzing circulating tumor DNA (ctDNA) in blood, offer real-time insights into tumor changes, helping to detect new mutations or resistance mechanisms that inform subsequent treatment choices. However, Professor Sonnenblick stressed that not all mutations are treatable, and molecular test results must be interpreted carefully, considering the disease's stage, prior treatments, and scientific evidence. The understanding that breast cancer encompasses diverse diseases with distinct biological profiles allows for more precise treatment selection, aiming for the right treatment for the right patient at the right time.