Advanced stages of Breast cancer not only include the metastatic disease but other complicated form of breast cancer which also includes inoperable locally advanced disease. There is a paucity of high quality research and clinical trials to answer a number of questions and there is an urgent need to invest funds for more research on this issue. Two European societies have published guidelines asking for increased research into the treatment for advanced stages of breast cancer.
Advanced treatment has increased the duration of survival but advanced stages of breast cancer are almost 100% fatal. The main aim of Doctors is to prolong and improve the quality of life of the patient.
It is in this background that a group represented by the European School of Oncology (ESO) and the European Society of Medical Oncology (ESMO) developed a second international guidelines for the management of Advanced Breast Cancer also known as ABC2.
Guideline co-chair Eric Winer, MD, of Dana-Farber Cancer Institute in Boston, told MedPage Today, “I don’t think that we generalize about individual patients. With each and every patient, we have to assess exactly what kind of breast cancer she has, where it has spread to, what other kinds of medical problems she has, and based on this info, give women — and occasionally men — a much better sense of their prognosis.”
Fatima Cardoso, MD, of the Champalimaud Cancer Center in Lisbon, Portugal who was the co chair of the panel issuing the guidelines said that the lack of progress was primarily caused by the lethargic pace of clinical development. The current thrust of the treatment schedule starts with patients who have metastatic breast cancer followed by the assessment of potential therapies for earlier stages, and finally with research in patients with advanced disease.
Cardoso said in a statement, “In one sense, this is correct because we need to provide the highest number of patients as early as possible with the new drugs. But if we do that all the time, we will leave the metastatic patients without any good knowledge of how to treat them.”
Cardoso points out that most breast cancer specialist are unaware about the use of trastuzumab (Herceptin) in metastatic disease until 10 years after it was known that it was effective. The same is the story with paclitaxel.