(Oct 2021) -The medical community’s treatments and understanding of breast cancer continues to improve.  Dr. Kanth Katragadda is a hematologist and medical oncologist at Clearview Cancer Institute. He recently sat down with The Rocket to talk about some of the promising new treatment options, new research and overall progress as it pertains to breast cancer.

To help people fully understand the recent advancements in the field, Katragadda started with a quick primer on the different types of breast cancer.

For starters you have two general types of cancer, metastatic, which means the cancer has spread somewhere else and non-metastatic, which means it hasn’t.  When you’re talking about breast cancer, he outlined three broad types: HER2, Triple Negative Breast Cancer and hormone breast cancer.

When doctors diagnose breast cancer, they look for the female hormone estrogen, the female hormone progesterone or the protein called human epidermal growth factor or HER2.  If estrogen, progesterone and HER2 is absent, then it’s called Triple Negative breast cancer.  What they find determines what types of treatments they can prescribe.

 Katragadda said there has been some major progress made when it comes to non-metastatic HER2 breast cancer.

 “At one point, HER2 was considered kind of a bad thing with a poor prognosis,” he said. “Now we’ve brought it up to the level of hormone breast cancer. The five-year outcomes are really great.  But, we are still fine tuning and finding new answers and trying to make things better.”

He said the treatment for HER2 used to be a “one size fits all.” The treatment normally would start with chemotherapy, followed by surgery and then the doctor would prescribe the same maintenance treatments regardless of if the patient had signs of cancer during the time of surgery or not.  Now, doctors can fine-tune that treatment thanks to a drug called Kadcyla, which Katragadda said has proven to be superior to the previous treatment options for those patients.

He said when it comes to HER2 in the metastatic setting, there has been an “explosion of new and better drugs” with four new drugs hitting the market last year and three coming to market this year.

Some of those drugs include advancements in antibody-drug conjugates that Katragadda says works more like a “smart bomb” when it comes to targeting cancer cells.

 “You can deliver a higher dose of the chemo specifically directed to the targeted cancer,” he said.

When it comes to triple-negative breast cancer, the most aggressive form of breast cancer, Katragadda said when they added the new drug Keytruda to the existing treatment regime it showed promising results.

It increased the chances for the patients not to show any sign of cancer at the time of surgery by 10% and the likelihood of being cancer free for the long-term improved by 37%, according to Katragadda.  Dr. Katragadda said strides have been made in the triple-negative, metastatic cancer.

 “When cancer progressed with the conventional treatment for people with triple-negative metastatic cancer, it was almost like they had no hope,” Katragadda said. “Right now, I have two patients who are on this chemo completely cancer free for the last year. Unheard of.”

 When it comes to non-metastatic hormone breast cancers, he said doctors have learned they can add a new chemo pill called Verzenio, which has significantly improved the survivability of people with larger tumors.

The same drug also has been shown to benefit patients with metastatic hormone breast cancer.  “We are getting better. We are trying to advance in areas where we are already better. And, we are looking at areas where we need growth,” he said.  "We’re seeing new research and new promising drugs coming up.”

 

Originally published in the Redstone Rocket Oct. 6, 2021