Breast cancer is not one single disease, but many

Ander Urruticoechea and Alex Prait, medical oncologists specialising in breast cancer

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In the early 2000s, breast cancer was divided into four types (luminal A, luminal B, HER2 positive [HER2+] and basal/triple negative breast cancer [TNBC]), but researchers now know other differences that can help drive new approaches to treatment.


“Thanks to our improved understanding of the biology of breast cancer, we can now diagnose it earlier and develop better therapies to cure more patients, improve survival and quality of life, and reduce the number of patients who need chemotherapy,” 

Dr Ander Urruticoechea, medical oncologist and scientific director, Onkologikoa, San Sebastian, Spain.

Three drugs (palbociclib, ribociclib and abemaciclib) are available for patients with luminal B, HER2 negative breast cancer that inhibit CDK4/6 cyclindependent kinases, which are essential for cell division and are often overactive in cancer cells. Promising results have been reported with the alphaspecific PI3K inhibitor alpelisib for tumours with mutations in the PI3K cell-signalling pathway.

Patients with metastatic breast cancer and the inherited BRCA1/2 mutation can benefit from the PARP inhibitor olaparib, which exploits DNA repair deficiencies in cancer cells.

“There are many drugs in early-phase clinical trials, and the challenge is now to match them with the tumour alterations and show that they are useful to patients,”

Professor Aleix Prat, head of medical oncology at the University of Barcelona, Spain.

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