Review of Available Treatments For Locally Advanced Breast Cancer

Review of Available Treatments For Locally Advanced Breast Cancer

shutterstock_214055650In a recent article published in the current issue of Nature Reviews Clinical Oncology, researchers reviewed the current state of available treatments for patients with locally advanced breast cancer (LABC).

LABC constitutes a heterogeneous entity that includes advanced-stage primary tumours, cancers with wide nodal involvement and inflammatory breast carcinomas that are difficult to treat. A high proportion of patients suffering from this condition relapse and many do not survive, making it vital to evaluate available treatments.

In the review titled “Management of locally advanced breast cancer—perspectives and future directions,” researchers argued there is an urgent need to standardize treatments and to develop therapies to improve clinical outcomes.

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Dr. Konstantinos Tryfonidis, EORTC Clinical Research Physician and lead author of this review said in a recent news release, “Locally advanced breast cancer is a term that includes a wide variety of breast tumors ranging from large operable cancers with extensive nodal involvement to inflammatory breast carcinomas. Indeed, some large operable breast tumors could fit in these categories, but we decided to limit our discussion to inoperable cancers. So, we are addressing, specifically, inoperable cases due to extensive skin involvement, fixed or very bulky axillary nodal disease and/or supraclavicular or internal mammary nodal involvement or tumors with inflammatory elements.”

Currently the EORTC (European Organisation for Research and Treatment of Cancer) has some proposals and ongoing clinical trials, including:

• EORTC 10085p – An international collaboration between the EORTC, BIG, TBCRC and NABCG focusing on the characterization of male breast cancer.
• EORTC 1307 – A randomised Phase 3 clinical trial testing the efficacy of Niraparib versus Physician’s choice in patients with a germline BRCA mutation and previously treated breast cancer.
• EORTC 75111 – A Phase II selection multicentre open label randomised trial of the Breast Cancer Group and the EORTC Elderly Task Force that is examining the efficacy of a combination of Pertuzumab and trastuzumab (PH) versus PH combined with metronomic chemotherapy (PHM) in elderly patients with HER2+ metastatic breast cancer that continue on T-DM1 after disease progression.
• EORTC 90091 – A clinical trial evaluating the efficacy of trastuzumab in patients with HER2-negative early breast cancer as an adjuvant therapy for circulating tumor cells.
• EORTC 1401 – The LORD trial, a multicentre randomised non-inferiority trial that is evaluating traditional therapy versus active surveillance of low risk. In this study the EORTC will be collaborating with BOOG.

Dr. Fatima Cardoso of the Champalimaud Clinical Centre in Lisbon, Portugal, and corresponding author of the study, stated in the news release, “The prognosis for patients with these tumors is often unfavorable, but advances in therapy offer some hope. Although not very often in developed countries, locally advanced inoperable breast cancer is still a challenging clinical problem in developing countries, particularly those without screening nor education/awareness programs. Managing the treatment of patients with this disease requires a multidisciplinary approach, and such an approach mandates a coordinated treatment schedule and close cooperation between medical, surgical and radiation oncologists. More and more, locally advanced inoperable breast cancer is drawing the interest of the oncology community, and as it was one of the main topics discussed at the Advanced Breast Cancer Symposium and Consensus Meeting 2 (ABC2) in Lisbon in November 2013.”