WHAT LIES BENEATH BREAST CANCER?
Not all breast cancers are the same. Some cancer cells grow slowly, while others mutate and multiply in an uncontrolled manner, which can be fatal.
And so, treating this life-threatening disease is, indeed, a journey. There’s the starting point, the road blocks along the way, and the destination.
“For women diagnosed with early breast cancer, the future is uncertain. The fear that cancer could come back may never go away completely,” shares Dr. Gia Sison, who was diagnosed with stage 2 breast cancer. “I have recurring thoughts of having a second cancer diagnosis. I hope not.”
Being diagnosed with advanced breast cancer can be even more difficult because the hope of staying well is replaced with the realization that a cure is no longer possible.
BREAST CANCER IS NO LONGER A DEATH SENTENCE
The good news is, there’s a new therapy that can provide better health outcomes for advanced breast cancer patients.
Medical research has been relentless in innovative therapies to improve patient outcomes — from the principle of precision medicine to targeted therapies based on driver mutations, immunotherapy and the like.
“Today, we celebrate the milestone in our fight against advanced breast cancer,” enthuses Dr. Arnold John Uson, president of the Philippine Society of Medical Oncology, at the launch of alpelisib, the FDA-approved treatment for advanced breast cancer. Discovered at the Novartis Institutes for BioMedical Research, alpelisib is the first-ever treatment specifically for HR+/HER2advanced breast cancer with a PIK3CA mutation.
WHY MUTATIONS MATTER
So why are there mutations in breast cancer? And what are the implications of these mutations to prognosis and treatment.
“First, we need to understand how genes cause cancer,” Dr. Eva Cutiongco-Dela Paz, executive director, National Institutes of Health; and director, Health Program of the Philippine Genome Center. “Inside every single cell in our body is a structure called the nucleus, the control center of the cell. Inside it are 23 pairs of chromosomes in which 20,000 genes can be found.”
Genes are coded messages that control how our bodies grow and develop.
“All cancers develop because something has gone wrong with one or more of these genes. The change in the gene is called a mutation,” Dr. Dela Paz, explains.
The PIK3CA is the most commonly mutated gene in hormone receptive positive (HR+/HER2) breast cancer.
PIK3CA mutations are associated with tumor growth, resistance to endocrine treatment, and a poor overall prognosis.
“Patients with PIK3CA mutation need to be identified through genetic testing because they face a worse prognosis,” adds Dela Paz. “Detection of PIK3CA gene mutation enables the identification of patients with HR+/HER2- advanced breast cancer, who might benefit from more effective personalized treatment with molecular targeted medicine.”
Approximately 40 percent of patients living with HR+/HER2- breast cancer have this mutation.
“I likened the PIK3CA testing to apps like Waze or Google Maps that show motorists the best route to their destination,” shares Novartis president Joel Chong. “And since treating cancer today is a journey, what we want to know is which roads are clear, and which roads are gridlock. We do this because we want to optimize our resources, we want to save time, we want to save money.”
By knowing which medicines work, and which medicines do not work, patients are better equipped to make decisions on when to spend money and when not to.
“This is the value and role of genetic testing,” notes Chong. “The PIK3CA mutation is a new target for breast cancer patients. If a patient does not have this target, then the patient doesn’t need this medication.”*
The testing can improve treatment outcomes and prolong survival among patients with advanced breast cancer.
“Knowing this early on helps both doctors and patients plan better by making educated decisions in their journey to overcoming cancer,” explains Dr. Dela Paz.
TARGETED THERAPY
To complement the availability of PIK3CA testing, Novartis Philippines introduces alpelisib, the first FDA-approved PIK3CA specific targeted therapy in the country.
“This new treatment option specifically addresses the needs of patients with this mutation,” enthuses Chong.
This is a step forward in personalized medicine, where patients will be confident when choosing treatments because they know in advance whether this drug will work for them or not.
“Through testing for PIK3CA mutations, patients are given a better chance of survival,” notes Dr. Dela Paz. “It’s such a landmark finding that will benefit our patients once they are tested and screened.”
STILL, THE FIGHT AGAINST THE BIG C CONTINUES
Even with PIK3CA testing and alpelisib, the fight against breast cancer continues. Cancer patients still have unmet needs from various aspects such as emotional, psychological, mental, and financial.
“We hope that the passing of the Universal Healthcare Law will be fully implemented as it will cushion the impact of this disease in Filipino lives,” notes Dr. Uson of the Philippine Society of Medical Oncology (PSM).