Breaking boundaries to advance breast cancer care

Written by:

Susan Galbraith

Executive Vice President, Oncology R&D, AstraZeneca 

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Sunil Verma

Senior Vice President, Global Head of Oncology, Medical, AstraZeneca

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If the breast cancer treatment landscape was a lap pool, researchers would have spent the last 50 years1 swimming in set lanes, identifying patients and treatments according to specific and well-defined categories. We have learned some new strokes during that time — uncovering valuable biological identifiers like HER2 and BRCA— but continued to swim in familiar lanes; HR+, HER2+, triple negative cancers2,3. Well that is now about to change. We have recently uncovered opportunities for treating patients based on target expression. This is opening new segments in breast cancer and requires us to re-evaluate these traditional categories for there are patients who may be eligible to receive novel and existing medicines based on better classification using current and novel diagnostics. In turn, this may alter the way some breast cancers are classified and treated, creating new swim lanes that will set us on a winning path for more patients.

As our understanding of breast cancer has evolved, we now understand that it represents a spectrum of diseases consisting of diverse subtypes that differ in biology, clinical response to therapies and overall outcomes4. Each patient’s breast cancer is unique and requires a personalised treatment approach5. Thankfully advancements in genetics, diagnostics, molecular biology and systems biology have expanded our ability to address this challenge by identifying and targeting specific subtypes of breast cancer4 in new ways and helping more patients.

With this knowledge and innovative new tools, a renewed mission for cancer care is possible. We are now aiming to treat breast cancer earlier, smarter, broader and fairer to make the greatest impact with the ultimate goal of improving — and prolonging — the lives of people with breast cancer.


Our mission: earlier, smarter, broader, fairer

Identifying and treating cancer earlier is critical to bringing impactful therapies and improving outcomes. We know that the best way to cure cancer is to identify the disease at an earlier stage6 and offer systemic therapies that can be given before or after surgery7. While many patients are treated with the current standard of care (SOC), we plan to improve patient outcomes through our portfolio and ongoing studies and hope to make meaningful advances in survival for people with breast cancer.

We also must continue to be smarter about treating breast cancer. We are investing in several screening and diagnostic technologies that aim to make this possible, such as harnessing circulating tumour DNA (ctDNA)8, collaborating with innovative testing partners, investigating treatments in earlier lines of cancer and intercepting cancer earlier before it leads to clinical progression.

To reach more patients whose needs are unmet with current strategies, we must also target a broader range of breast cancers to create deeper levels of impact. In addition to developing the new therapies that we hope will replace current SOC, we are evaluating novel combinations of therapies with an aim of leading to greater efficacy and more sustained benefit by helping to prevent or delay the emergence of treatment resistance.

And finally, employing a fairer approach to drug development is critical to reaching all patients affected by breast cancer, including minority populations affected disproportionately as it relates to treatment outcomes9. To do this, we are adapting our clinical trial programmes to be more accessible and inclusive, working to deliver affordable options for patients, and identifying and addressing barriers to access and care9.


Using science to change the breast cancer treatment paradigm

Our advancements in these four categories are underpinned by our commitment to boldly following the science with the patient need at the forefront and bringing our multi-pronged approach to redefine breast cancer care.

On the one hand, we are pursuing a strong and diverse pipeline to target the many drivers of breast cancer. This includes developing a range of new medicines such as immunotherapies, antibody drug conjugates, and small molecule inhibitors and degraders. Breakthroughs in areas such as ctDNA and computational pathology are also helping us understand how patients respond to these therapies8 so that their regimes can be tailored and adjusted for the best possible outcomes.

To complement this research, we are utilising new tools, such as digital technology and patient-reported outcomes, to assess and address how patients respond to a medicine, with the ultimate aim to improve the patient experience. This involves accessing real-time, patient-generated data that can help us refine our approach to treatment. In combination with clinical trials, real-world data also helps us better understand the impact of our medicines in the real-world outside of a controlled clinical trial environment10.

We also appreciate the power that external partnerships can bring to our efforts and collaborate with others to achieve shared goals. Our work with TEMPUS, for example, aims to transform cancer outcomes by bringing the power of real-world data to ensure that the evidence from our clinical trials is benefiting patients in a real-world setting. 


Turning our vision into reality

We’re in a new era in breast cancer research and care. We have made incredible strides for patients, breaking the swim lanes and diving for more answers because there is still work to be done. Alongside industry, clinicians, researchers, academics and patients, we will continue with our ambition to harness innovative scientific developments, pursue valuable collaborations and develop innovative therapies to redefine treatment pathways for patients that may improve lives. 





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References:

  1. Cancer Research UK. Cancer in the UK 2019. Accessed 26 May 2022 from http://www.cancerresearchuk.org/sites/default/files/state_of_the_nation_april_2019.pdf
  2.  Godoy-Ortiz A et al. Deciphering HER2 Breast Cancer Disease: Biological and Clinical Implications. Front Oncol. 2019; 9: 1124
  3.  Chavez K J et al. Triple Negative Breast Cancer Cell Lines: One Tool in the Search for Better Treatment of Triple Negative Breast Cancer. Breast Dis. 2010; 32(1-2): 35-48.
  4.  Yersal O and Barutca S. Biological subtypes of breast cancer: Prognostic and therapeutic implications. World J Clin Oncol. 2014; 5(3): 412-424.
  5.  Mendes E. Personalized Medicine: Redefining Cancer and Its Treatments. American Cancer Society. April 2015. Accessed 23 May 2022 from http://www.cancer.org/latest-news/personalized-medicine-redefining-cancer-and-its-treatment.html
  6.  World Health Organization. Promoting Cancer Early Diagnosis. Accessed 26 May 2022 from http://www.who.int/activities/promoting-cancer-early-diagnosis
  7.  Cleveland Clinic. Metastasis (Metastatic Cancer). Accessed 26 May 2022 from http://my.clevelandclinic.org/health/diseases/22213-metastasis-metastatic-cancer
  8.  Muendlein A et al. Significant impact of circulating tumour DNA mutations on survival in metastatic breast cancer patients. Scientific Reports. 2021; 11(6761).
  9.  Hamel L M et al. Barriers to Clinical Trial Enrollment in Racial and Ethnic Minority Patients with Cancer. Cancer Control. 2016. 23(4); 327-337.
  10.  Health Analytics. Health Economics and Outcomes Research. March 2022. Accessed 26 May 2022 from http://www.healthanalytics.com/health-economics-and-outcomes-research/

Veeva ID: Z4-39238
Date of preparation: May 2022