Sep 9, 2009 7:32 pm US/Eastern
Health Watch: Personalized Breast Cancer Treatment
NEW YORK (CBS) ―
Successful treatment of breast cancer begins with early detection. Mammography is still the gold standard. But recent years have brought sonograms to separate cysts from tumors as well as MRI's and PET scans to detect tumors that may not show on mammograms. But there's still a place for old-fashioned breast self-exams.
"I was just, one day just sort of fiddling around and felt some tenderness in my breast. And this was actually in 2004 that I felt some tenderness in my breast," said Michelle Marquez, breast cancer survivor.
Her mother died of breast cancer and Michelle was just 40 when she herself was diagnosed with breast cancer. Partly as a result, she went to work for the Susan G. Komen Foundation in New York, but not before she went through the full range of breast cancer treatments.
"I had a mastectomy on the right side and I also underwent chemotherapy and radiation therapy," Michelle said.
Michelle was treated at Memorial Sloan-Kettering Cancer Center where virtually every woman has their breast cancer characterized after it's removed, essentially fingerprinting the tumor to determine its genetics and what fuels its growth. This then leads to a treatment plan that is specific for that individual tumor - personalized cancer therapy.
"We're discovering that breast cancer is really an assortment of diseases and that there can be subgroups characterized by different biologies of the cancer," said Dr. Tiffany Traina.
The most commonly defined breast cancer characteristics are molecular receptors that stick out on the surface of the cancer cell. When a growth factor attaches to the receptor, it sets off a cascade of biochemical events that fuel the cancer cell.
The first such receptor that was identified was estrogen, followed by progesterone. Both are female hormones that induce some breast cancers to grow.
The good news is that there are drugs that can interfere with these receptors.
"By disrupting estrogen, particularly attacking receptors for estrogen, found in many breast cancer cells, we can make that breast cancer cell divide less," said Dr. Norton.
Treatment usually means chemotherapy plus drugs that block these hormone pathways, including tamoxifen, raloxifene and aromatase inhibitors such as arimidex, femara and aromasin. Researchers have also found another growth factor receptor, the her-2 protein that led to the development of herceptin, an antibody that blocks that receptor and also starves the cancer cell.
But as many as one in five women have a breast cancer without any of those receptors - triple receptor negative. For those women there's new hope.
"In a subset of these estrogen receptor negative breast cancers, targeting androgen may be very important in their biology and treatment," Dr. Traina said.
Androgen is actually a male sex hormone and there's an already approved drug, bicaludimide, that blocks it. In clinical trials so far it's slowing cancer growth with minimal side effects.
(© MMX, CBS Broadcasting Inc. All Rights Reserved.)
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