One new targeted therapy for metastatic breast cancer arrives in Brazil and shows that he is capable of reduce the risk of disease progression or death by 50% . The treatment, developed by biopharmaceutical company AstraZeneca, was approved in May by the National Health Surveillance Agency (Anvisa) and is now available on the market.
Breast cancer is caused by the disordered multiplication of abnormal cells in the breast. According to the National Cancer Institute (Inca), the disease caused 18,361 deaths in 2021, 18,139 of which were women.
The treatment consists of a novel combination of capivasertib a new therapy, with fulvestrant an already known hormonal therapy. It is recommended for cases of breast cancer progression in the metastatic or recurrence setting, during or within 12 months after completion of adjuvant treatment.
New therapy targets specific type of cancer
There are different subtypes of breast cancer, with rapid or slow development. Metastatic breast cancer is cancer that has already spread to other organs in the body.
Additionally, there are three broad categories of breast cancer:
- luminal : one that has relatively strong expression of hormonal receptors (estrogen and progesterone) and in which the HER-2 protein is not overexpressed (HER-2 negative);
- HER-2 positive : is one that, in general, has strong expression of the HER-2 protein on the cell surface, with or without hormonal receptors;
- Triple negative : is one that has no expression of either the HER-2 protein or hormone receptors.
The target of the new therapy is luminal type tumor locally advanced or metastatic with one or more changes detected in one of the three pathways PIK3CA, AKT1 or PTEN . These pathways regulate cell proliferation and growth, being essential for maintaining the physiological metabolism of normal cells in the body.
In cases of breast cancer, activating mutations in PI3K and AKT are capable of increasing the proliferation and invasion of cancer cells.
According to the book “Beating breast cancer: Prevent, treat and cure “, from the Instituto Vencer o Câncer, around 40% of breast tumors have a mutation in the PIK3CA gene which leads to the activation of this pathway and, consequently, increases the proliferation of tumor cells. Additionally, 5 to 10% of advanced breast tumors harbor activating AKT mutations.
How does the new therapy work?
Capivasertib, present in the new therapy, is the first AKT inhibitor approved by the Food and Drug Administration (FDA), in the United States, and by Anvisa. This component inhibits the action of the AKT pathway, leading to a reduction in the risk of progression or death for patients who have cancer with alterations in the PIK3CA/AKT/PTEN pathway.
Antônio Carlos Buzaid, medical director of the Oncology Center at Hospital Beneficência Portuguesa in São Paulo and co-founder of the Instituto Vencer o Câncer, explains to CNN that the new therapy is indicated for patients who have already undergone treatment, or are undergoing it, and whose tests indicate tumor progression .
“Imagine a breast cancer patient who is receiving a medicine we call an aromatase inhibitor together with a cyclin inhibitor [um tratamento padrão para esse tipo de câncer]. However, tests show that the tumor is growing. At this time, we will check whether the patient carries a mutation in one of these pathways that function as a motor for cancer cells”, he explains.
“The patient who was identified with the mutation in the AKT pathway may be a candidate for treatment with the new therapy, which blocks the action of this pathway, killing cancer cells,” he adds.
Results of studies with capivasertib
In studythe effectiveness of the combination of capivasertib with fulvestrant was evaluated in comparison with placebo for the treatment of locally advanced (inoperable) or metastatic breast cancer.
The global trial involved 708 adult patients with locally advanced or metastatic HR-positive or HER-2-negative breast cancer, of which 289 patients had tumors with alterations in the PIK3CA/AKT1/PTEN pathway.
The primary objectives of the work were progression-free survival in the general population of patients and in the population of patients whose tumors presented alterations in the PI3K/AKT pathway (PIK3CA, AKT1 or PTEN genes). According to the study, there was a 50% reduction in the risk of progression or death, compared to the combination of placebo with fulvestrant in patients with changes in PIK3CA/AKT/PTEN2 biomarkers.
In the view of Karina Fontão, executive medical director of AstraZeneca Brazil, the new therapy is a solution for women who did not respond to standard treatment, giving more hope and more time free from disease progression.
“Our first-in-class AKT inhibitor consolidates precision medicine in the treatment of breast cancer in Brazil, with the potential to change clinical practice by expanding treatment approaches for patients who show tumor progression or resistance to previously used endocrine-based therapies” , notes Fontão.
“The combination also meets the need for treatment for a considerable population of patients with specific biomarkers, contributing to a significant reduction in the risk of progression or death from the disease at a locally advanced and metastatic stage”, comments Fontão.
This content was originally published in Metastatic breast cancer: new treatment reduces risk of progression by 50% on the CNN Brasil website.
Source: CNN Brasil
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