Why are some types of breast cancer so hard to treat? Let's talk about these new treatments (Hard-to-Treat Breast Cancer)

When someone is diagnosed with breast cancer, they feel very sad and scared. That's normal. But with today's advanced medical science, most types of breast cancer can be controlled and cured. However, there are some types of cancer that are a little harder to treat than others. These are called "hard-to-treat breast cancers." Medical researchers have high hopes for this, because new treatments are being developed every day. Let's talk about this today.

Why are some breast cancers challenging to treat?

Simply put, the most successful breast cancer treatments aim to control how cancer cells grow. Think of it this way: if a cancer cell is like a door, certain hormones and proteins are like the keys that open that door. Treatments work by blocking the doors (receptors) so that these keys don't work. Breast cancer is divided into three main types based on the type of 'doors'.

Now let's see what these three types are.

Triple-negative breast cancer (TNBC) accounts for 10% to 20% of all breast cancers. Hormone treatments that are effective for other types of cancer do not work in this type of cancer, because it does not have hormone receptors. Also, drugs that target HER2 do not help.

In addition, TNBC cancer is more aggressive than other types. This means that the cancer is more likely to have spread to other parts of the body by the time it is diagnosed. It also behaves differently in each person, and can change over time to become resistant to certain medications.

How do genetic mutations affect this?

One of the best ways to detect a cancer like TNBC early is to identify those at high risk. To do this, researchers are studying genetic changes (mutations) that are passed down through generations and are associated with breast cancer.

• BRCA1 ( breast cancer gene 1)
• BRCA2 (Breast Cancer Gene 2)

If you inherit a mutation in one of these two genes, you are at higher risk of developing breast and ovarian cancer. If you have this mutation, you are also more likely to develop cancer at a younger age.

Most breast cancers with a BRCA1 gene mutation are triple-negative . Therefore, understanding this gene could help find better ways to treat TNBC.

What do you need to know about metastatic breast cancer?

Another type of cancer that is difficult to treat is breast cancer that has spread to distant parts of the body. This is called metastatic breast cancer . It can spread to other parts of the body, such as the bones, brain, liver, or lungs. Sometimes the cancer is diagnosed when it has spread this way. But more often, the cancer comes back and spreads after an initial round of treatment, sometimes years later.

If your breast cancer has spread to distant sites like this, the main goal of treatment is to keep the cancer under control. Systemic therapy is the most common treatment for this. Your doctor will decide on your treatment based on your symptoms, previous treatments, where the cancer has spread, and the type of cancer cells.

What are the latest treatments for this?

Treatments for TNBC, metastatic and recurrent breast cancer, have improved significantly in recent years. Chemotherapy is the main treatment for this. Doctors now give it in combination with other drugs.

Here are some other new treatment options:

PARP inhibitors

These are a type of drug that destroys the DNA of cancer cells in people with BRCA gene mutations and HER2-negative and metastatic cancer. Examples include `olaparib (Lynparza)` and `talazoparib (Talzenna).` These have also shown good results for early-stage TNBC.

Immunotherapy

These treatments stimulate the body's own immune system to destroy cancer cells. Pembrolizumab (Keytruda) is one such drug. They are usually given in combination with chemotherapy.

Antibody-drug conjugates (ADCs)

This is a very interesting technology. Think of it like a GPS system that guides a drug to its target. The antibodies in these drugs find cancer cells, attach to them, and destroy the cancer cells with the attached drug, without harming healthy cells. `Sacituzumab govitecan (Trodelvy)` is an ADC drug approved for advanced TNBC.

Add-on therapies

There are several new drugs that are given in combination with hormone therapy for hormone receptor (HR)-positive cancers. Abemaciclib (Verzenio) is one such drug.

What are the future prospects in this regard?

Researchers are constantly working to expand treatment options for these cancers, including finding new immunotherapy compounds and identifying markers that can predict treatment outcomes.

They are also investigating whether drugs approved for other diseases will be useful for TNBC. They are also investigating ways to use drugs like PARP inhibitors more broadly. Some studies are also trying to use nanoparticles that are beneficial to the body to kill drug-resistant cancer cells.

So, while living with this type of cancer can be challenging, there is hope for new treatments. The most important thing is to talk to your doctor regularly and decide on the treatment plan that is best for you.

Breast cancer, breast cancer, Triple-Negative Breast Cancer, TNBC, cancer treatment, genetic testing, BRCA1, BRCA2, Immunotherapy, metastatic cancer, Sri Lanka