Download CuRRENT STANdARdS Of CARE fOR METASTATIC BREAST

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Current Standards
of Care for Metastatic
Breast Cancer
While living with metastatic breast cancer can present challenges, there
are a number of treatment options available. With ongoing research,
more advances are being made every year.
fact sheet
Treating metastatic breast cancer may include a mix of treatment
options such as hormonal therapy, chemotherapy, radiation therapy,
surgery and targeted therapies.
These treatments focus on
maintaining a patient’s quality of
life while minimizing side effects.
The goal for many patients is to
stay on treatment as long as it
is successfully relieving symptoms
and stopping tumor growth.
Maintaining good communication
with the members of your health
care team is especially important to
discuss how treatment is affecting
your quality of life.
TREATMENT OPTIONS
Hormonal Treatments
Doctors generally recommend hormonal therapy for estrogen receptor—
or progesterone receptor-positive breast cancer that is either early stage or
metastatic. These treatments prevent estrogen from attaching to receptors
on breast cancer cells. As a result, estrogen cannot get in the cells, and tumor
growth is slowed.
There are many drugs that can be effective in treating hormone-receptor
positive breast cancer, including tamoxifen (Nolvadex and others), aromatase
inhibitors such as an anastrozole (Arimidex), letrozole (Femara), and exemestane
(Aromasin) and fulvestrant (Faslodex). Tamoxifen is effective both before and after
menopause, but all aromatase inhibitors only work in postmenopausal women.
Targeted Treatments
Targeted treatments are drugs that are directed against specific cell mechanisms
thought to be important for cancer cell survival and growth. This targeting helps
spare healthy tissues and causes fewer side effects than chemotherapy. There
are many targeted treatments for patients, including newer drugs and drugs
that have been available for a number of years. Tamoxifen was the first targeted
therapy developed for breast cancer and is still used today. Trastuzumab
(Herceptin) is a monocolonal antibody that targets HER2, an antigen that is
overexpressed on tumor cells. Lapatinib (Tykerb) also targets HER2.
(over)
The Importance of Clinical Trials
None of the advances in metastatic breast cancer
treatment would be possible without clinical trials.
People who take part in these studies receive state-ofthe-art care and often gain access to and benefit from
new medicines, which are being developed every year.
Your doctor can guide you in making a decision about
whether a clinical trial is right for you. Here are a few
things you should know:
• Before you take part in a clinical trial, you will be
fully informed as to the risks and benefits of the trial.
•
No patient receives a placebo (a look-alike containing no active ingredient) when there is a standard treatment available. Most clinical trials are designed
to compare a new treatment to a standard treatment to find out whether the new treatment has any
added benefit.
• You can stop taking part in a clinical trial at any time for any reason.
CancerCare Can Help
CancerCare’s professional oncology social workers are
available to work with you one-on-one to develop strategies
for coping with the challenges of cancer. CancerCare also
provides support groups, education, financial assistance
and referrals to other resources. To learn more about
how we help, call us at 800-813-HOPE (4673) or visit
www.cancercare.org.
Everolimus (Affinitor) was recently approved
by the U.S. Food and Drug Administration
(FDA) for the treatment of postmenopausal
women with advanced breast cancer. The drug
boosts the effectiveness of hormone therapy.
In 2012, the FDA also approved a monocolonal
antibody, pertuzumab (Perjeta) for women
with HER2-positive metastatic breast cancer
as first-line treatment in combination with
trastuzumab and docetaxel.
Chemotherapy
Chemotherapy is still used as a treatment for
metastatic breast cancer and is sometimes
used in combination with other agents.
Research advances are producing new
chemotherapy drugs and also revisiting the
use of older drugs by using them in different
schedules, combinations and dosages to
maximize the benefits. Drugs used to treat
metastatic breast cancer include taxanes such
as docetaxel (Taxotere), paclitaxel (Taxol)
and albumin-bound paclitaxel (Abraxane),
anthracyclines such as doxorubicin
(Adriamycin) or epirubicin (Ellence) or
capecitabine (Xeloda).
During the course of your treatment, it’s
important to remember that doctors are trying
to maintain a balance of keeping your cancer
under control and maintaining your quality of
life as best as possible. Living with metastatic
breast cancer can be stressful and difficult for
patients and their families. But as you work
with your health care team to care for your
emotional, psychological and physical well
being, you can feel empowered and in charge
of your care.
This fact sheet was made possible by a grant from Celgene.
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