About breast cancer
When normal cell division in the breast becomes uncontrolled, extra cells can form a mass called a tumor, which can be noncancerous (benign) or cancerous (malignant). Cancerous or malignant breast tumors can often be removed, but can grow back, invade surrounding tissues and organs, and spread to other parts of the body.
Treatment for breast cancer is based on the stage of the patient’s disease and can include surgery, chemotherapy and radiation. Targeted therapies have also become part of the standard treatment process.
For instance, hormone receptor-positive (HR+) breast cancer is characterized by hormone receptor-positive tumors, a group of cancers that express receptors for certain hormones such as estrogen and progesterone. Cancer cell growth can be driven by these hormones.2 The presence of estrogen receptor (ER) and/or progesterone receptor (PgR) is one of the most important predictive and prognostic markers in human breast cancers, and is collectively referred to as hormone receptor-positive.3
Novartis Oncology has a broad research and development program in breast cancer drugs, including efforts on targeted therapies for HR+ cells or cancers, as well as mTOR.
Novartis Oncology is committed to developing innovative new cancer drugs, such as targeted therapies for HR+ cancers and improving access to them through patient assistance and cancer resource programs.
Treatment of HR-positive breast cancer
Recurrence is the return of cancer after treatment. When breast cancer has spread to lymph nodes and/or other tissue in the area of the breast, but not to distant sites in the body, it is known as locally advanced breast cancer (stage III). When the cancer has spread to other parts of the body, such as the bones or liver, it is known as metastatic breast cancer (stage IV) and is the most serious form of the disease.4 Locally advanced and metastatic breast cancer is collectively referred to as advanced breast cancer. These distant recurrences are the primary cause of death from breast cancer.
For patients whose initial diagnosis is advanced breast cancer, and to help prevent recurrence in postmenopausal women with hormone-sensitive early breast cancer, aromatase inhibitors are frequently prescribed by physicians. Aromatase inhibitors are a medication that reduces the amount of hormones such as estrogen in the body, and are a form of endocrine therapy. They are an important advancement in breast cancer treatment in women with an HR+ tumor who have undergone surgery as they have been shown to reduce the risk of recurrence.
While endocrine therapy remains the cornerstone of treatment for women with HR+ breast cancer, most women will eventually develop treatment resistance.5 Therapeutic resistance has been associated with overactivation of the PI3K/AKT/mTOR pathway.5
One type of medication, called an mTOR inhibitor, may be used to help treat some women with HR+/HER2-negative advanced breast cancer and works differently than aromatase inhibitors. This type of medication targets the mTOR pathway, which is hyperactivated in many types of cancer cells and acts as an important regulator of tumor cell division, blood vessel growth and cell metabolism.5
Questions to ask your doctor
When you are diagnosed with breast cancer, you may want to ask your doctor questions like these about your diagnosis and treatment plan:
- What type of breast cancer do I have?
- What stage is my breast cancer?
- What cell markers does my cancer have?
- What are my treatment choices?
- What are the expected benefits of each kind of treatment?
- What are the risks of each treatment?
- What are the side effects of each treatment?
- How will we know if this is working?
- How will each treatment affect my daily life?
- Are there new treatments or clinical trials that I should consider?
- What are the chances of the cancer coming back again?
- What are my chances of being cured?
- Novartis Data on File
- What You Need to Know About Breast Cancer (National Cancer Institute) Web site. Available at http://www.cancer.gov/cancertopics/wyntk/breast. Accessed October 1, 2013.
- Osin, PP, Lakhani, SR. The Pathology of Familial Breast Cancer. Immunohistochemistry and Molecular Analysis. Breast Cancer Research. October 1999;1(1):36-40.
- Breast Cancer Staging (American Joint Committee on Cancer) Web site. Available at: http://www.cancerstaging.org/references-tools/quickreferences/Documents/BreastMedium.pdf. Accessed October 1, 2013.
- Baselga, J. Everolimus in Postmenopausal Hormone-Receptor-Positive Advanced Breast Cancer. New England Journal of Medicine. 2012;1-10.
- O'Shaughnessy, J. Extending Survival with Chemotherapy in Metastatic Breast Cancer. The Oncologist. October 2005;10(suppl.):20-29.
- Osborne CK, Schiff R. Mechanisms of Endocrine Resistance in Breast Cancer. Annual Review of Medicine. September 2011;62:233-47