How to Succeed With Breast Ca... Video Transcript

Webcast Transcript

Breast cancer is such a heterogeneous disease, meaning that if you have 20 women with breast cancer in the room, they may have 10 different kinds of cancers that act biologically very differently, that respond to different treatment programs. So the treatment really has to take that woman's individual cancer into consideration and also that woman's individual characteristics. What other diseases does she have? What is she at risk for? What is her age, her menopausal status? And then you can decide better.

RENEE KEMP: In the event of a relapse, will changing the adjuvant regimen improve success?

HOPE RUGO, MD: Changing the program upfront may not change things for a woman if she's unlucky enough to have her cancer come back. So when you come in and you already have established metastatic breast cancer, breast cancer that has spread to other organs, does it matter what treatment you got earlier on? Probably it doesn't matter very much.

The only situation that we'd be concerned of is in women who might be getting Herceptin that can cause some weakness in the heart. You might want to give them an anthracycline that causes less heart toxicity early on in their breast cancer. So somebody who has HER2/neu positive breast cancer, you might choose epirubicin to try and reduce their risks of heart problems in the future if they ever need Herceptin.

RENEE KEMP: There has certainly been a lot of discussion lately about biologic therapy and targeted therapy. Just what is that?

HOPE RUGO, MD: Target therapy is therapy that is targeted specifically to some biologic event in the cancer cell that makes the cancer cell grow, invade, metastasize, do all the things we think of as representing cancer cell growth.

The chemotherapy we have now is what we call sort of global cell kill. It's targeted against rapidly dividing cells so that's why your hair falls out. I mean those are rapidly dividing cells.

Our goal in the long term is to shift some of the treatment towards treatments that are targeted specifically for that cancer so they're not going to cause those other side effects.

RENEE KEMP: Dr. Rugo, if you would look into your crystal ball, look into the future and tell me what do you see on the horizon for these new therapies?

HOPE RUGO, MD: It looks right now that some combination of standard chemotherapy with novel agents will likely be the best approach.

Another way to look at this is to say, "Well, maybe we should stimulate the immune system." So there are a lot of vaccine trials that are being tested. And there are other targets, such as blocking the growth of new blood vessels, antiangiogenesis agents. Blocking growth factor receptors. So the way I see the future going is to try and map out how these novel agents work -- where they work the best, how they work, and then design combinations that are going to attack the cancer from multiple different areas. It's kind of like when you're thinking about designing a battle, where you're going to attack from. All different areas because we know that these cancers can learn to grow in the area that is not being blocked.

RENEE KEMP: Thank you very much for joining us, Dr. Rugo. And thank you for joining our webcast. I'm Renee Kemp.

Related Videos

Anthracyclines in Adjuvant Breast Cancer Therapy: Survival Benefits
The Pros and Cons of Breast Cancer Adjuvant Therapy
Which Adjuvant Therapy is Right for Your Breast Cancer?
Anthracyclines for Breast Cancer: Does Stage Matter?
Better Breast Cancer Therapy: Making Anthracyclines More Effective