Treatments for breast cancer have developed and improved rapidly in recent years and this pace of change is likely to continue, according to the Chair and Co-Chair of EBCC-14.
“This is good news for our patients,” says the Chair, Professor Michail Ignatiadis, Director of the Breast Medical Oncology Clinic & Programme at the Jules Bordet Institut, Associate Professor at the Université Libre de Bruxelles, Belgium, and Chair of the Breast Cancer Group at the EORTC.
As a medical oncologist, Michail has seen an acceleration in new developments in clinical research for both early and advanced breast cancer.
“In early breast cancer, drugs such as such as pembrolizumab, ribociclib and abemaciclib have decreased the rate of disease recurrence. Moreover, genomic tests have helped patients and physicians to avoid unnecessary adjuvant chemotherapy. In metastatic breast cancer, CDK4/6 inhibitors, anti-PD1 inhibitors or new Antibody Drug Conjugates have extended the survival of patients with this disease,” he says.
Co-Chair of EBCC-14, Dr Fiorita Poulakaki, Head of the Breast surgery Department at Athens Medical Centre Hospital, Greece, and Vice President Europa Donna, the European Breast Cancer Coalition, says: “Personalised medicine has helped patients get more conservative treatments, for instance with de-escalation of surgery at the axilla and more breast conserving surgeries in the breast. The result is a better quality of life for our patients without long term side effects. The increased use of neoadjuvant chemotherapy has been a very important change for surgical planning, and it has improved the outcomes of our work as well.”
Michail and Fiorita expect presentations at EBCC-14 to point the way for further, even more rapid developments in the future, with artificial intelligence, personalised medicine and genomics among the innovations that have the potential to change the landscape in breast cancer treatment.
“I believe we will see more new drugs approved and increased use of genomic tests in either tissue or blood to inform treatment decisions,” says Michail. “These changes will lead to widespread adoption of precision medicine. Finally, artificial intelligence will fundamentally reshape many aspects of treatment care and research.”
Fiorita predicts that “more and more genes will be associated with breast cancer to help us identify the group of patients who are at high risk of developing the disease.”
She continues: “I expect to see more tailored therapies with drugs that will improve the response to neoadjuvant chemotherapy. This will make breast conserving surgery with minimal surgery at the axilla more feasible. In years to come, I think the extent of surgery in the axilla will be even more minimal; sometimes it might even be omitted. There are many trials investigating this and we expect the results soon.
“In addition, I expect a subgroup of patients with low-risk ductal carcinoma in situ could have the option of close surveillance instead of surgery and radiotherapy. This could make a huge difference to the quality of life for some of these patients.”