What are the Treatment Options for Late-Stage Breast Cancer?

This section provides information about what those options are — from targeted therapies to chemotherapy — and when these various treatment options can be used. It also provides information on new, exciting research that is currently being tested in clinical trials and information about when recently approved drugs, like immunotherapies, can be used. While there have been many developments in recent years when it comes to treating late-stage breast cancer, which therapies can be used will depend on the characteristics of the patient’s cancer.

Late-stage breast cancer is not one disease, but many different diseases — so the options available to different patients vary a great deal. Which treatment doctors recommend will depend on several factors like a woman’s overall health, genetics, the biology of the tumor, and more.

New Developments for Advanced Breast Cancer

HER2-positive breast cancer

For women with HER2-positive breast cancer, meaning they have high levels of a protein called HER2 on the surface of their cancer cells, targeted treatments are available. The drugs trastuzumab (Herceptin) and pertuzumab (Perjeta) have transformed the outlook for some women with late-stage breast cancers. These therapies, which are often combined with chemo, are very effective at controlling breast cancer once it has spread.

Exciting new research has also indicated that women with metastatic HER2-“low” breast cancer may have new options as well. In the past, doctors divided patients into two categories based on HER2 expression: HER2 positive tumors and HER2 negative tumors. Recently, however, researchers have looked to further expand this definition to include patients who have a minimal amount of HER2 expression but do not meet the classic definition for HER2-positive tumors. This means there could be more treatment options for women who fall in this HER2-“low” category.

Dr. Elizabeth Comen explains what HER2-“low” means.

Triple-negative breast cancer

Another big advancement has come in the treatment of triple-negative breast cancer. This has historically been one of the most aggressive and hardest to treat forms of the disease, because it lacks any of the main drivers of breast cancer — the estrogen receptor, the progesterone receptor, and the HER2 receptor — and it doesn’t respond to treatments that target these receptors.

Now, in addition to chemotherapy, immunotherapy has been approved to treat triple-negative breast cancer. In studies, this new therapy has been shown to extend the lives of women with this type of cancer.

Recently, a new antibody drug conjugate showed promise in extending life and progression-free survival in some women with triple negative breast cancer as well.

Hormone-receptor-positive breast cancer

For postmenopausal women with hormone-receptor-positive and HER2-negative breast cancers, a newer class of drugs called CDK4/6 inhibitors are available. These drugs have been shown to improve survival in some women with metastatic cancer.

Estrogen receptor-positive means that this type of cancer needs the hormone estrogen to grow. These CD4/CD6 drugs work to decrease the amount of estrogen that can be taken into a cancer cell, with the goal of slowing the rate at which that cancer cell can expand.

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