Australia’s BreastScreen program has had some astonishing success.
According to the Australian Institute of Health and Welfare, breast cancer mortality has decreased by an amazing 50 per cent since BreastScreen Australia began, from 74 deaths per 100,000 women aged 50–74 in 1991, to 37 deaths per 100,000 women in 2022.
Treatment has come a long way in the past few decades. Often the only option was a mastectomy and aggressive chemo and/or radiation.
However, while treatment has improved, one thing that doesn’t get much attention is that while patients are often cured of the disease, the long-term effects on their health can be devastating. They include nerve damage, poor adrenal function and long-term heart damage.
Long-term trials
A long-term trial is hoping to improve those outcomes.
For more than a decade, the University of California, San Francisco (UCSF), has been working on the I-Spy group of studies, which aim to accelerate the development of new therapeutics for early stage breast cancer. While the ultimate aim is to help patients live, the trial is also designed to lead to fewer complications and predict good long-term outcomes. It is making some fantastic progress.
“I-SPY 2.2 is the latest in the I-SPY family of trials and introduces a very patient friendly and straightforward trial design. Ultimately, the goal is to find and develop biologically targeted treatments that help get each patient to the best possible outcome, with the least toxicity. I firmly believe this trial is going to do just that,” said Laura Esserman, principal investigator of I-SPY 2.2, director of the UCSF Breast Care Center and co-leader of the UCSF Breast Oncology Program.
Promising outcomes
Recent results of I-Spy 2.2 have discovered a treatment regime with promising outcomes. Among 106 patients with HER2-negative breast cancer, 50 per cent of the patients overall had a complete response, or disappearance of all signs of cancer. Importantly, for the patients who achieved a complete response, more than 50 per cent achieved this without any standard chemotherapy, and over 90 per cent did not need doxorubicin-cytoxin (AC), one of the standard treatments that is particularly toxic.
“It is pretty exciting to see this pace of release of important results,” said Dr Esserman.
“It’s a promising therapy combination that can eliminate standard chemotherapy in many patients, particularly the immune-positive subtype.”
The patients were given personalised treatment plans to combat any side-effects.
“The ability to tailor treatment to biology and the observed response represents an exciting advance in personalised therapy,” said Dr Esserman.
“We have demonstrated that it is possible to conduct a randomised trial that enables individualisation of care within the trial. This is a patient-centric feature that makes patients want to participate in these studies. The lessons from this arm and every arm we evaluate continue to inform us and allow us to learn and improve the design.”
The trial is ongoing, and the researchers are making adjustments based on patient experiences and treatment outcomes.
Another intriguing finding from the trial is that 35 per cent of patients with luminal B breast cancer, a subtype that shows particularly low rates of response to chemotherapy, showed no or minimal residual disease after going through the treatment strategy.
Have you had breast cancer? Was there long-term health damage? Why not share your experience in the comments section below?
Also read: How BreastScreen Australia has halved breast cancer deaths
