Seminar shares targeted therapy for breast, prostate cancer treatment

May 23, 2024 - 16:42
Experts shared new targeted therapy for breast and prostate cancer treatment at a recent scientific seminar in Hà Nội.
Chairman of the Vietnam Urology - Nephrology Association Lê Đình Khánh speaks at the event. — Photo courtesy of the organiser

HÀ NỘI — Experts shared new targeted therapies for breast and prostate cancer treatment at a scientific seminar which was jointly organised by the Cancer Prevention Research Institute and Vietnam National Cancer Hospital, in collaboration with AstraZeneca Vietnam.

The seminar featured presentations by international experts and leading Vietnamese experts in breast cancer and urology.

Experts said that in the era of precision medicine, targeted therapies are proving effective against many different types of cancers. Notably, PARP inhibitors have been approved in several countries for multiple types of ovarian, breast, prostate, and pancreatic cancers, offering significant benefits for patients. These therapies can help extend life expectancy, improve disease-free survival rates, and enhance overall patient survival.

The workshop updated the latest clinical data showing the role of PARP inhibitors in two patient groups: early-stage breast cancer, HER2 negative, with hereditary BRCA1/2 mutations and breast cancer. Metastatic castration-resistant prostate cancer has no indication for chemotherapy.

Emphasising the importance of BRCA1/2 gene mutation testing in early-stage breast cancer patients, Associate Professor, PhD. Phùng Thị Huyền, Head of Internal Medicine Department 6, K Hospital, said "Testing for BRCA 1/2 gene mutations is an important step to help surgeons and internists have a comprehensive patient management plan, including decision-making. For patients with early-stage, high-risk breast cancer who have inherited BRCA1/2 gene mutations, are HER2-negative, and have been treated with neoadjuvant or adjuvant chemotherapy, PARP inhibitors are an approved treatment option in Việt Nam and are recommended by reputable associations.”

Data from the OlympiA study showed that this high-risk patient group using Olaparib significantly prolonged overall survival and nearly 90 per cent of patients were alive after four years of treatment. To date, OlympiA is the only study with clinical data showing a statistically significant survival improvement in patients with HER2-negative early breast cancer.

The combination of new-generation endocrine therapy and PARP inhibitors for the first stage for patients with castration-resistant prostate cancer has been demonstrated through clinical studies, including the PROpel study. The results showed that the group of patients using this combination had a progression-free survival time of up to more than two years, an increase of more than eight months compared to the comparison group, and the overall survival time of the combination arm was over 42 months.

This effect was consistent across different subgroups, based on HRR mutation status, metastasis status, symptoms, or prior chemotherapy treatment. Adverse events were all manageable and similar to the side effects of each drug, such as anemia, fatigue, nausea, or high blood pressure.

Chairman of the Vietnam Urology - Nephrology Association Lê Đình Khánh said: “Although patients still have some treatment options, the outcome remains poor and less than 50 per cent of patients can receive further treatment at step 2. This situation highlights the need for aggressive treatment and effective selection at step 1. The study results support the combination of targeted therapy and new-generation endocrine drugs as the new standard of care for these patients.”

In Việt Nam, breast cancer is the most common cancer in women, with more than 24,000 new patients and more than 10,000 deaths annually (according to Globocan 2022). Data show that nearly 70 per cent of cases are diagnosed in the early stages. However, 20-30 per cent of patients will progress or metastasise, especially in high-risk patient groups with clinical characteristics such as young age, a large tumour, positive lymph nodes, high histological grade, and BRCA1/2 gene mutation. Among these characteristics, BRCA1/2 gene mutation is associated with specific clinical features, a worse clinical course, and poor treatment outcomes. Therefore, treatment needs to be individualised to improve overall patient survival.

For men, prostate cancer is the fifth most common cancer in Việt Nam, with more than 5,800 new patients and 2,800 deaths annually. Metastatic castration-resistant prostate cancer (mCRPC) is a disease with a poor, heterogeneous prognosis and often leads to death. — VNS