Innovative Medicines Play Key Role in Treating Breast Cancer

Early detection coupled with innovative technologies and medications are crucial to reducing breast cancer mortality rates in South Africa, writes Dr Mothobi Godfrey Keele, Head of Government Affairs and Policy, Innovative Pharmaceutical Association of South Africa (IPASA).

 

Given that South Africa recently observed Breast Cancer Awareness Month, the occasion has reminded us of the plight that continues to face South Africans, irrespective of gender, race or age in relation to cancer. Considering that breast cancer is among the most commonly diagnosed types of cancer1 and the most prevalent cancer in women2, its impact on mortality rates is significant.

 

As the second leading cause of cancer-related deaths in women3, reducing global breast cancer mortality rates by even 2.5% annually will avert 25% of breast cancer-related deaths by 2030 and 40% by 2040 amongst women under 70 years4.

 

Occurring when the cells within the breast grow out of control, several factors lead to the development of breast cancer including age, genetic mutations and family history. While the disease is more prevalent in women, it can occur in men too. In the same fashion, breast cancer symptoms can present in many ways, including lumps, pain, skin irritations and discharge, amongst others5.

 

In South Africa, the prevalence of breast cancer is burgeoning, and while most common amongst white and Asian women, it remains the second most common cancer among black and coloured women6.

 

Statistical data published in the National Cancer Registry in 2017 confirmed the severity of the disease in South African women, stating that one in 26 are at risk of developing breast cancer with as many as 16% potentially succumbing to the disease. Concerningly, many women present with late-stage cancer, making prognosis and treatment difficult. It is therefore imperative that early detection procedures are bolstered to successfully combat the disease2.

 

Early detection is instrumental in combating breast cancer, and this includes conducting monthly breast self-examinations, going for routine screening, and receiving annual mammograms for women aged 40 years and over, even if they are symptom-free7.

 

Apart from increased awareness and screening initiatives, some of the greatest interventions in combating the severity of breast cancer are innovative pharmaceutical medications, many of which are having a significant impact on reducing breast cancer mortality rates.

 

With around 80% of breast cancers being hormone receptor (HR) positive8, certain types of medication have proven effective in delaying the need for chemotherapy and extending survival rates whilst the use of specific types of oncology medicines that block cell-cycle progression has been shown to reduce mortality rates of patients with metastatic breast cancer9.

As amongst the highly acclaimed medicine regulatory agencies, obtaining approval in terms of marketing authorisation by the United States’ Food and Drug Administration (FDA) is evidence of the medications’ thorough testing and approval processes.

 

In the case of HER2-Positive breast cancer, the FDA has green-lit the use of a number of medications, including those that prevent HER2-mediated signalling, and those that inhibits activation of HER2 and HER3 resulting in inhibition of anti-tumor activity, and microtubule inhibitors that activates lysosomal degradation. Use of any of the mentioned types of anti-cancer medicines are all dependent on the characteristics of the patient’s cancer9.

 

Furthermore, for patients with HER2-Low breast cancer – a newly defined subtype that accounts for more than half of all metastatic breast cancers – a recent clinical trial has identified another new innovative anticancer medicine that boosted the survival of patients with HER2-low breast cancer compared with chemotherapy, and is receiving accelerated approval by the FDA for patient use9.

 

As the most difficult to treat owing to the lack of both hormone receptors and HER2 overexpression, triple-negative breast cancer has, in the past, seen chemotherapy become the primary source of treatment. In recent times, however, this has changed, with new innovative pharmaceuticals becoming available.

 

While the medications to treat breast cancer are quickly being approved and implemented as viable treatments, more needs to be done to create awareness and bridge the accessibility gap amongst potential patients across rural South Africa. This includes promoting preventative strategies to mitigate the risk of breast cancer and driving early detection and screening awareness to reduce the rising incidence of breast cancer diagnosis in the country.

 

The rapid evolution of innovative medical and pharmaceutical interventions shows promise in the pharmaceutical industry’s ability to someday drastically reduce breast cancer mortality, and by promoting awareness and driving medical accessibility, more South Africans will be cancer survivors and an example to those who are just beginning their journey’s in fighting the disease.

 

References:

 

  1. Current and future burden of breast cancer: global statistics for 2020 and 2040 [Internet]. [cited 2022 Oct 6]. Available from: https://www.iarc.who.int/news-events/current-and-future-burden-of-breast-cancer-global-statistics-for-2020-and-2040/#:~:text=Breast%20cancer%20is%20the%20most,between%20countries%20and%20world%20regions.
  2. Early Detection of Breast Cancer is Vital [Internet]. CANSA – The Cancer Association of South Africa. The Cancer Association of South Africa; 2021 [cited 2022 Oct 6]. Available from: https://cansa.org.za/early-detection-of-breast-cancer-is-vital/
  3. Breast Cancer Statistics [Internet]. [cited 2022 Oct 6]. Available from: https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html
  4. Breast cancer [Internet]. [cited 2022 Oct 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer#:~:text=Reducing%20global%20breast%20cancer%20mortality,under%2070%20years%20of%20age.
  5. CDCBreastCancer. What Is Breast Cancer? [Internet]. Centers for Disease Control and Prevention. 2022 [cited 2022 Oct 6]. Available from: https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm
  6. Breast Cancer Awareness Month 2022 [Internet]. [cited 2022 Oct 6]. Available from: https://www.gov.za/BreastCancerAwarenessMonth2022
  7. Infographic: BIG 5 Cancers Affecting Women in SA [Internet]. CANSA – The Cancer Association of South Africa. The Cancer Association of South Africa; 2017 [cited 2022 Oct 7]. Available from: https://cansa.org.za/infographic-the-big-5-cancers-affecting-women-in-sa/
  8. Cancer Resources from OncoLink, Treatment, Research, Coping, Clinical Trials, Prevention. Hormone Receptor (HR) Positive Breast Cancer [Internet]. [cited 2022 Oct 21]. Available from: https://www.oncolink.org/cancers/breast/screening-diagnosis/hormone-receptor-hr-positive-breast-cancer#:~:text=If%20your%20tumor%20has%20hormone,of%20breast%20cancers%20are%20HR%2B.
  9. Advances in Breast Cancer Research [Internet]. National Cancer Institute. 2019 [cited 2022 Oct 25]. Available from: https://www.cancer.gov/types/breast/research
  10. Shange N, Kgatitswe LB. Breast Cancer Awareness Month: Black women in rural areas are still on the margins of life-saving messages [Internet]. Daily Maverick. 2020 [cited 2022 Oct 25]. Available from: https://www.dailymaverick.co.za/article/2020-10-22-breast-cancer-awareness-month-black-women-in-rural-areas-are-still-on-the-margins-of-life-saving-messages/