Joyce A. O'Shaughnessy, MD, Co-Director, Breast Cancer Research, Baylor Charles A. Sammons Cancer Center, Texas Oncology, US Oncology in Dallas, TX, describes that the future of breast cancer treatment will include improved monitoring practices, more knowledge of disease biology, and new agents.
The number of biopsies completed needs to increase in metastatic disease overall and biopsies need to be repeated at multiple intervals for patients with longer histories. In addition to biopsies real-time monitoring will become more important in the next 5 years using circulating tumor cell changes as an indicator.
O'Shaughnessy believes the outlook for HER2-positive breast cancer is very bright as more agents are made available and new subtypes are discovered potentially through the evaluations of phosphoproteins.
In estrogen receptor (ER) positive breast cancer an increased understanding of the biology of indolent cancer will lead to a better interpretation of treatment options. Exploring the molecular pathogenesis and necrosis may lead to the realization that indolent ER-positive breast cancer requires prolonged endocrine therapy.
Treatments for aggressive ER-positive breast cancer require an increased familiarity of the disease’s molecular and pathway abnormalities. Various trials are currently underway for aggressive ER-positive cancer; including the BOLERO-2 trial examining everolimus (Afinitor) and the entinostat (SNDX-275) phase II trial that was presented at the 10th Congress on the Future of Breast Cancer.