A Clearer, Better, Stronger Way to Fight Breast Cancer

Knowing the genetic make-up of each tumor will help treatment teams hone in on the best fix

It is a word that terrifies most of us.

“One of my biggest fears is going to the doctor and being told I have cancer,” said a young mother of three from Baltimore.

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Treatments on the horizon may soon be tailored precisely to any disease — including cancer. And while that’s comforting, the question is whether these can come fast enough.

Precision medicine is quickly becoming a reality, according to cancer researcher Eran Andrechek, Ph.D., of Michigan State University.

“HER2+ve breast cancer is treated with Herceptin, CML (leukemia) with Gleevec, EGFR mutant lung cancer with Gefitinib. These are precision medicines — and treatment is a reality. Our work is now identifying how to match drugs with patients that don’t fit into an existing therapy,” Andrechek told LifeZette

“There are numerous interesting projects in progress to further refine diagnosis through blood tests that will need FDA approval,” said one cancer researcher.

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Andrechek’s lab is one of many nationwide that are working to understand the genetic differences that often occur within even a single breast cancer tumor. Better understanding the genetic make-up of any tumor will help cancer treatment teams establish a defined, proven treatment plan specific to that tumor’s biomarkers.

“We’ve moved from screening hereditary cancer for BRCA mutations to adding several tests that can refine diagnosis, including OncotypeDX, and more recently PAM50,” he said.

OncotypeDX is a genomic test that analyzes how a cancer is likely to behave and respond to treatment. It also helps physicians figure out a woman’s risk of recurrence, or how likely she is to benefit from chemotherapy or radiation therapy after surgery.

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PAM50 stands for Prediction Analysis of Microarray 50. It tests a sample of the tumor (removed during a biopsy or surgery) for a group of 50 genes. The results do much of the same as the above — they help determine the benefit of using chemotherapy in addition to hormone therapy, the likelihood of metastasis and the molecular subtype of breast cancer.

If tests show a fairly high risk of metastasis, a more aggressive treatment plan that includes both hormone therapy and chemotherapy may be advised; meanwhile, a lower score could mean hormone therapy alone may be considered, according to the Susan G. Komen website.

The goal is always to offer patients the best possible treatment and outcome with the least side effects — and to make the one-treatment-fits-all formula a thing of the past. It doesn’t work.

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One recent study showed that for breast cancer patients alone, one in three women is treated unnecessarily with either surgery, radiation or chemotherapy. Screening tests found tumors that are so slow-growing that they’re essentially harmless.

“There are numerous interesting projects in progress now to further refine diagnosis through blood tests that will need FDA approval. Treatment has also changed and continues to change,” said Andrechek.

Families facing a diagnosis are counting on it, as they look for the best possible way to fight and survive a cancer diagnosis. While the technology and understanding of tumor genetics develops, patients should ask their cancer team about the availability of genetic testing, as the treatments that follow could foster more positive outcomes.

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