On July 14th 2022, an article from The Guardian described the announcement that two new breast cancer drugs are now available.
The two new drugs, Alpelisib (also known as Piqray) and Trodelvy (also called Sacituzumab Govitecan) are finally now available on NHS England, after previously being rejected earlier on this year.
Around 3,500 women with incurable secondary breast cancers will now benefit from these life-extending drugs after being approved by the National Institute for Health and Care Excellence (NICE).
Alpelisib, when used with a hormone therapy called Fulvestrant, targets the gene that causes fast growing tumours, by blocking the gene’s ability to help cancer cells to survive and ultimately grow. A previous study showed that half of those who received the treatment were able to stop the growth of their cancer for six months.
Trodelvy will be used to treat breast cancer that cannot be removed surgically. This will be of great news to women with incurable Triple Negative Breast Cancer. The treatment will target a protein on the surface of the tumour cells, which eventually will cause them to die. Clinical trials have shown a person’s life can be extended by about five months by slowing down the progression of the disease.
Even though neither drug will sadly cure patients of their advanced breast cancer, their lives will be extended and will be of a better quality, giving them more precious time with their loved ones.
We asked Dr Sacha Howell, Senior Clinical Lecturer and one of our experts, for his thoughts:
For Alpelisib, the approval offers a valuable new approach to treatment for patients with cancers that have the PIK3CA mutation. The genetic test for this mutation in advanced breast cancers was also recently approved on the national genomics test directory and is freely available to all women with oestrogen receptor positive Her2 negative breast cancer. If the mutation is identified then Alpelisib, in combination with the anti-oestrogen Fulvestrant, offers approximately 6 months delay in cancer progression and the requirement for chemotherapy. The side effects of Alpelisib treatment require careful management but overall quality of life did not deteriorate significantly with this combination, and it represents a valuable new tool in the fight against stage 4 breast cancer.
Trodelvy (Sacituzumab Govitecan) is an exciting new drug used to treat advanced triple negative breast cancer. Trodelvy is a class of drug called an antibody-drug conjugate, meaning that an antibody that recognises a protein expressed on 90% of TNBC (TROP2) is bound to a potent chemotherapy agent which is then delivered directly to the cancer cells. The advantage of this approach is that patients experience far fewer side effects than would be experienced if the same chemotherapy was delivered on its own. Trodelvy, used after at least two standard types of chemotherapy showed impressive activity in inducing cancer shrinkage, prolonging cancer control and most importantly doubling the length of time patients stayed alive. Treatment is generally well tolerated and this approval is excellent news for patients with difficult to treat, advanced Triple Negative Breast Cancer.