Progress in Five Minutes: Marching Toward a Breast Cancer Cure

Women have lived with, and died from, breast cancer for millennia. And though breast cancer remains the deadliest cancer that women experience worldwide, cases have been consistently on the decline for decades. Breast cancer survival rates tripled for women studied at a Texas cancer hospital over 60 years, from a 25.1 percent survival rate in 1944–1954 to 76.5 percent in 1995–2004. Mortality rates were down 40 percent in 2017 from 1989. Experts credit the hundreds of thousands of lives saved to early detection, improved treatment options, and the discontinuation of hormone replacement therapy. 

There’s still a lot of work to be done, to be sure: an estimated 281,550 women in the United States are expected to be diagnosed with invasive breast cancer this year, and an estimated 43,000 will die from the disease. Recently, the mortality rate stopped declining for women under 40, and decades of research disparity need to be addressed to better understand breast cancer in women of color. But there’s a lot to be hopeful about, too, including new drugs and screening methods to effectively treat, and maybe one day end, the disease. 

Game-changing Treatment for Fast-spreading Breast Cancer

There’s been a lot of hype this fall—and rightfully so—for a relatively new drug from pharmaceutical company AstraZeneca called Enhertu, with recent trial results finding the drug is very successful at treating incurable breast cancer.

AstraZeneca announced at a September conference that Enhertu halted cancer progression for 12 months for 72 percent of patients versus those being treated with T-DM1, a drug that is currently widely used for treatment of HER2 positive breast cancer. (HER2-positive is a breast cancer that spreads more rapidly than other types.) Then, in October, the United States Food and Drug Administration (FDA) granted Enhertu Breakthrough Therapy Designation, which is expected to fast track the drug’s development and regulatory review. 

An estimated one in five people with breast cancer are HER2-positive. Enhertu has been approved for use in the US, Japan, European Union, Israel, and the United Kingdom for those who have received two or more prior treatments of anti-HER2 drugs. Another very promising number from the study is that after one year of use, almost all, 94.1 percent, of Enhertu patients were alive, compared to about 85.9 percent of patients treated with T-DM1 drugs. 

Dr. Sara Tolaney, an oncologist at Dana-Farber Cancer Institute who was on the study’s research team, told ABC News that the drug will “dramatically change the treatment for HER2 positive breast cancer.”  

Chemo: No Longer a Foregone Conclusion

Chemotherapy destroys cancer cells and prevents the body from making more of them, but healthy cells can also be damaged during the treatment, resulting in harsh side effects like nausea and vomiting, fatigue, and hair loss. Chemotherapy drugs have been used since the mid-20th century to treat many cancers, and though it has saved many lives, chemotherapy’s one-size-fits-all approach might be on its way out. 

Last December, the US federal medical research agency National Institutes of Health (NIH) said that some post-menopausal women can be successfully treated for HER2-negative breast cancer without chemotherapy. This recommendation, as from the NIH press release, “may save tens of thousands of postmenopausal women each year the time, money, and harmful side effects that come with chemotherapy infusions.” A recent story in The New York Times called this approach a “quiet revolution in breast cancer treatment” that is slowly reducing the number of patients that are recommended chemotherapy, as genetic testing and other targeted treatments become more beneficial. 

Cancer-detecting Artificial Intelligence

We’ve long known that early detection saves lives. And now, thanks to AI, this crucial finding can take a matter of seconds and reduce the manpower needed to do it. 

One such company developing AI early detection technology is Hamburg, Germany–based Mindpeak, whose software significantly shaves off the time needed to diagnose cancer in cells. A (human) pathologist traditionally examines potentially cancerous cells using a microscope, which can take up to 10 minutes. Mindpeak’s algorithm takes seconds, and is already being used by labs in the US, Germany, and Poland.

Such software can make a huge difference in places like the United Kingdom, where a pandemic backlog of cancer screens needs an estimated 2,000 more radiographers to clear it. In an article for TechCrunch, Thomas Clozel, a doctor and cofounder of the medical research company Owkin, says that AI is “intended to augment, not replace, human doctors.” Clozel pointed to the UK’s radiographer shortage as well as to new low-cost and portable screening devices being developed in India and an at-home test kit being developed in Spain as examples of AI’s potential. These solutions can reach women who might not have access to a doctor or cancer screenings, or who have been prevented from going to the doctor during pandemic lockdowns.

mRNA to the Rescue . . . Again

The technology that allowed the Covid-19 vaccine to be created in weeks, not years, strikes again! Seriously, after mRNA cures us all of Covid, the flu (in one shot ever, not one shot a year,) malaria, etc., etc., we expect it to continue making our lives better in ways we can’t imagine. 

mRNA works by “teach(ing) our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies,” according to the Centers for Disease Control and Prevention (CDC). BioNTech, the company that created the first approved Covid vaccine using mRNA and partnered with Pfizer for distribution, recently said that the company has two mRNA cancer drugs in trials, as does Moderna. BioNTech is currently in phase two of a clinical trial for an mRNA melanoma drug, and the company expects to have several cancer drugs ready for patients in the next five years.

While we’re used to understanding the job of mRNA vaccines as preventing disease, mRNA vaccines for cancer are actually meant to treat it. This new, personalized mRNA treatment approach is showing positive results for other cancers, including pancreatic and non-small lung cell cancers.