Expanding the medical landscape in breast cancer treatment: Personalized medicine
Balancing the cure with the care
When a pharmacy employee asked whether she’d like to donate during Breast Cancer Awareness Month, comedian Nicole Osborne, a stage four breast cancer survivor, joked, “No, I’m pretty aware.”
Although Osborne is living far longer than anyone predicted and receives standing ovations at Stand Up NY performances, behind every joke is a shred of truth: Are patients aware of all their options? Are patients treated as individuals? This is where personalized medicine can help physicians create customized treatment plans and better care for each patient as a unique individual.
Research reveals that the side effects of current breast cancer treatments significantly reduce quality of life for both patients and survivors. The result? Patients often beat cancer but tragically find themselves unable to live the way they did prior to treatment because of the serious and long-lasting effects of chemotherapy and other interventions.
Personalized medicine aims to transform the outcomes of breast cancer patients and survivors by:
- Determining which patients are most likely to benefit from a particular treatment, which ensures patients only receive treatments that are likely to treat their cancer.
- Identifying the patients most likely to experience serious side effects from treatment, ensuring that patients are provided with the safest treatment and the best chance of survival.
Side effects of breast cancer therapies
According to experts, chemotherapy side effects are categorized as either long-term or short-term. Common short-term chemo side effect is trouble with short-term memory, sometimes called “chemo brain.” Other short-term side effects include hair loss, mouth sores, nerve damage, fatigue, loss of appetite, nausea and an increased risk of developing infections.
Conversely, long-term symptoms experienced by breast cancer patients and survivors who have undergone chemotherapy include those such as cardiac damage, infertility, leukemia, and cognitive dysfunction which goes beyond memory loss.
Innovations in personalized medicine have helped to address a number of chronic side effects. They are outlined in the following table.
Personalized Medicine Approach
Chemotherapy-induced menopause (CIM) is known to affect about 13% of younger breast cancer patients and survivors. Studies have shown that it can also lead to rib fractures and fragile bones.
Stratifying an individual’s condition and proactively choosing the best medication while tailoring the dose to a patient’s particular requirements.
Women being treated for breast cancer are likely to likely to suffer irreversible cardiac damage as a result of certain cancer therapies such as trastuzumab.
Researchers at Stanford have discovered a process for identifying patients who are likely to suffer cardiac damage as a result of cancer therapies.
This breakthrough has provided oncologists with the information they need to better predict patient success with certain agents through identification of which patients will most likely benefit from the treatment and which patients would most likely be at risk of cardiac damage.
Chemotherapy-induced peripheral neuropathy
Changes in the nerves outside of the spinal cord and brain can cause numbness and tingling in the patient’s extremities, making daily tasks like walking and writing exceptionally challenging. This reportedly affects 45% of breast cancer survivors.
Chemotherapy-induced peripheral neuropathy may be managed with predictive analysis.
Cognitive dysfunction most commonly affects older breast cancer patients.
Selecting interventions that minimize or prevent cognitive loss or dysfunction by measuring biomarkers to distinguish between proinflammatory, metabolic, neurotrophic and depressive endophenotypes. Based on the endophenotype, the treatment can be tailored to the patient.9
A combination of chemotherapy, hormonal therapy, and ovarian removal or shutdown contributes to increased risk of depression among patients receiving treatment for breast cancer.
While depression responses and treatments vary, future research is focusing on moderator effects and how a treatment response can be manipulated.
How does all of this help in the “personalization” of disease management?
Today, precision medicine allows clinicians to make decisions about a single patient based on information about that patient specifically – no assumptions are necessary when there is science behind the treatment plan. In this way, patients proactively receive the right cancer treatment in the right dose and at the right time, which can potentially lead to remission or a cure.
The future of breast cancer and disease management in general, will be data-driven. Personalized medicine development is focusing on treatment-associated side effects and the benefit-risk ratio, in an effort to formulate personalized therapies that will alleviate long-term undesirable effects.
Snowfish has partnered with leading diagnostic companies in areas of breast and prostate cancers and helped them to better understand the treatment paradigms and stakeholder ecosystems that are integral and driving disease management. To learn more please reach out to firstname.lastname@example.org.