A new strategy against an aggressive type of breast cancer is one step away from receiving state approval.

BarcelonaBreast cancer is one of the cancers with the best prognosis, but not all diagnosed cases behave the same way, and some tumors do not respond well to treatment. For example, one in five patients worldwide has the HER2-positive (HER2+) type, which, when it metastasizes, is highly aggressive and has a high capacity for proliferation. New targeted therapies have radically improved survival, but there are still patients who end up developing metastases despite receiving treatment or who are diagnosed at advanced stages, when the prognosis is worse. Now, a team led by the breast cancer group at the Vall d'Hebron Institute of Oncology (VHIO) has demonstrated in a study that there is a more effective strategy than the current one for these patients. The drug is on the verge of receiving approval from the national health system. Researchers at VHIO, led by Cristina Saura, head of the breast cancer unit at Vall d'Hebron Hospital and of the VHIO breast cancer group, have improved the prognosis for patients with a therapeutic combination using two cancer drugs. These are two antibodies administered together to patients with HER2+ metastatic breast cancer who have not yet received other treatments or chemotherapy. According to the studies, this drug duo reduces the risk of disease progression or death by 44% compared to the standard treatment currently offered in the public healthcare system. According to the conclusions of the study published this Tuesday in the journal The New England Journal of Medicine, On average, patients treated with the experimental combination went 40 months without disease progression compared to 26.9 months for patients who received standard treatment.

Thus, the researchers believe these results could lay the groundwork for a change in clinical guidelines, allowing these patients to receive the therapeutic combination they have evaluated instead of their current treatment. Saura defends the importance of this type of clinical study because it offers early access to the treatment "within a therapeutic gap" while its funding is being negotiated for its integration into the healthcare system, which can take about two years in Spain.

Pending Challenges

One of the major challenges remaining with this promising combination of treatments is controlling the toxicities they can generate. For this reason, a new study is underway across Europe called Topreal, focused on the early detection and management of adverse effects. Saura is also the principal investigator of this study and argues that it is crucial for obtaining more scientific evidence on how to improve the quality of life of patients with this new strategy. It will be conducted jointly with research groups in France and Germany, under the leadership of the Solti academic group, with the ultimate goal of improving the quality of life of patients during treatment for metastatic breast cancer.