Encouraging advances for prostate and breast cancer

Novartis Headquarters in Basel, Switzerland, October 25, 2011

These are two hopes in the treatment of advanced forms of particularly frequent cancers: those of the prostate and breast. Recent data suggests that it is possible to prolong the life of some patients.

They were presented at the annual congress of the European Society of Medical Oncology (Esmo), one of the world’s major cancer research meetings, which ends on Tuesday.

These results provide avenues for prolonging the survival of patients with advanced forms of two of the most common cancers in men and women, respectively: that of the prostate and that of the breast.

Both leave great chances of survival if diagnosed early, but these decrease dramatically when metastases have developed.

Before 2015, less than half of men with prostate cancer with multiple metastases could expect to live more than three years, recalls oncologist Karim Fizazi in a statement from Esmo.

From now on, “they can expect to live more than five years”, assures Mr. Fizazi, based on a study which he presented to the congress and which was published in the journal of Esmo.

What changed ? Until 2015, advanced prostate cancer was only treated in one way: by blocking the production of hormones like testosterone in the patient.

Then a chemotherapy treatment, docetaxel, was proven effective and began to be used in the mid-2010s.

Soon after, another drug was added to the arsenal. Abiraterone has recorded good results by acting like the first treatments on hormones but in a different way.

It was three tracks. But how to articulate them? Until now, the rule was to choose two: either add chemotherapy to traditional treatments, or add abiraterone.

Finally, we can go further by playing on all fronts, according to the study presented by Mr. Fizazi. After five years, patients treated with all three types of treatment have a much higher survival rate than those who did not receive abiraterone.

For the authors of the study, the conclusion is clear: we must change the way we treat the most serious cancers of the prostate, with a combination of the three treatments.

They are not alone in thinking so: “These results will change the standards of care,” said Maria De Santis, an oncologist outside the study, in an article published by Esmo.

– “Still a lot of work” –

This could happen quickly, she says, because the treatments involved are all easily accessible. It is enough to articulate them in a new way.

For breast cancer, it is not a new combination of drugs that is the subject of great interest, but new data on the effectiveness of a particular treatment: ribociclib, developed by the Swiss company Novartis .

Here again, it is patients at an advanced stage of the disease who are concerned. More specifically, these are postmenopausal women suffering from so-called HR + / HR2- cancers, which account for half of the forms with metastases.

Ribociclib is one of a class of treatments that seek to limit the action of a protein that promotes tumor growth in the breast. These drugs are not given on their own but with other treatments that slow down the production of estrogen.

But their effectiveness remains questionable. The main molecule in this category, palbociclib from the American Pfizer, has not been shown to prolong the life of patients in its clinical trials.

However, patients who received ribociclib generally survived longer than those who were given a placebo, according to a study led by oncologist Gabriel Hortobagyi and funded by Novartis.

Half of the former survived more than five years, while the figure drops to 4.3 years in half of those who received a placebo.

While these data should be taken with caution, while waiting for the study to be independently reviewed, it was widely praised at the congress.

There is “still a lot of work to be able to cure these patients but it is a very important result”, judged on Twitter the oncologist Matteo Lambertini, who did not participate in the study.

LNT avec Afp

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