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This is good news for women with triple-negative breast cancer, a form of aggressive, hard-to-treat breast cancer that targets women under 50 years of age.
A new study published Saturday in the New England Journal of Medicine revealed that a combination of chemotherapy and antibody-based drugs has taught the woman's immune system to attack cancer cells, sometimes prolonging life. nearly one year old.
"This is the first time that immunotherapy has worked on a cancer that is so difficult to treat, and represents a big step forward for these breast cancer patients," said lead author Dr. Peter Schmid. communicated. He presented his findings at the conference of the European Society of Medical Oncology in Munich, Germany on Saturday.
"This is a breakthrough that will allow us to help more people," said Dr. Larry Norton, oncologist of Memorial Sloan Kettering, who did not participate in the study. "Once we get regulatory approval, I think it will change the standard of care."
Triple negative breast cancer
About one in ten breast cancers is triple negative, according to the National Breast Cancer Foundation. It is most likely to affect Hispanic and African-American women and those with a BRCA1 gene mutation. It also tends to attack women in their forties and fifties.
"It is particularly tragic that those affected are often young," said Schmid, and will likely continue to raise families. "We have been desperate for better treatment options."
When breast cancer cells do not have estrogen, progesterone or human epidermal growth factor (HER2) 2, this is known as triple negative breast cancer. Therefore, it does not meet any of the available hormonal treatments for cancer.
He responds to chemotherapy. However, for most women, cancer cells quickly develop resistance to chemotherapy. This allows aggressive cancer to spread to other parts of the body, reducing survival rates.
The study found that in this trial, the combination of drugs and chemotherapy prolonged progression-free survival for at least 10 months. The risk of spread of cancer in other parts of the body and the risk of death have also been reduced by 40%.
"This is only the beginning of the use of immunotherapy for breast cancer," said Norton, who heads breast center Evelyn H. Lauder at the Memorial Sloan Kettering Cancer Center.
Scientists are learning "so much and so quickly about other ways to boost the immune system," said Norton, who he predicts an "explosion of well-designed studies that will advance the program."
How it works?
The new treatment combines the medicine of atezolizumab immunotherapy with traditional chemotherapy.
In a normal state, the immune system does not attack cancer cells because they are considered part of the body. That's where atezolizumab comes in. It's an antibody that binds to the cancer cell. His job is to inactivate a protein called PD-L1, which is responsible for telling the immune system "do not attack me".
Chemotherapy is also needed to "harden" the outside of the cancer cell, explained Schmid. This allows the newly developed immune system to recognize and attack the invader.
"We use chemotherapy to snatch the" immune protective coat "from the tumor to expose it," Schmid said, "thus allowing the immune system of people to get it."
The Phase 3 study enrolled more than 900 women enrolled in 246 sites in 41 countries, who were randomized to receive atezolizumab and chemotherapy, or placebo and chemotherapy.
Standard chemotherapy was given weekly. Atezolizumab was administered intravenously every two weeks.
Women who received immunotherapy and chemotherapy survived without cancer progression for an average of 7.5 months, more than two months longer than women taking chemotherapy and placebo.
In women tested positive for PD-L1, particularly high levels of protein, the response was even better. By the end of the trial, these women had added another 2.5 months to their lives.
"We are particularly encouraged by the fact that some patients live without recurrence for an extended period," Norton said. "Discovering why these patients are doing so much better than others will be one of the important topics for future research."
The trial was funded by Roche, the manufacturer of atezolizumab.
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