Novartis drug offers new tack in cancer treatment

MANILA, Philippines - Endocrine therapy remains the cornerstone of treatment for postmenopausal women with hormone receptor-positive (HR+), HER2/neu-negative (HER2-) advanced breast cancer.

However, most patients will eventually develop hormone treatment resistance, which has been associated with over-activation of the mTOR pathway.

A product of research-based Swiss pharmaceutical company Novartis, everolimus offers a new approach to cancer treatment by continuously inhibiting mTOR, a protein that acts as a central regulator of cancer cell division, cell metabolism and blood vessel growth.

“mTOR is the switch that activates cancer cells to divide and grow; everolimus turns off this switch. With its unique mechanism of action, everolimus can help address endocrine treatment resistance,” said Dr. Mario Campone, medical oncologist in the Institute of Oncology West-Rene Gauducheau and professor of medical oncology at the University of Angers in France. 

Campone was the guest speaker in a scientific symposium entitled “Countering The Resurgence: Endocrine Resistance In Breast Cancer” held last Oct. 19 at the EDSA Shangri-La Hotel in Mandaluyong City.

Organized by Novartis Healthcare Philippines in cooperation with the Philippine Society of Medical Oncology and Philippine Breast Cancer Society, the symposium was attended by local medical oncologists, general surgeons, surgical oncologists, radiation oncologists, pathologists, internists, and oncology nurses.

“Everolimus has the potential to redefine the treatment and management of advanced hormone receptor-positive breast cancer, offering a critical new option for physicians and patients,” said Dr. Maria Luisa Tiambeng, director of the Cancer Center of Cardinal Santos Medical Center.

“We welcome the development of novel targeted cancer therapies such as everolimus, which will help improve the management of advanced breast cancer in the country,” said Dr. Roselle de Guzman, medical oncologist at St. Luke’s Medical Center.

According to Campone, endocrine therapy is the cornerstone of treatment for patients with HR+ breast cancer while aromatase inhibitors have become the first-line treatment of choice.

When disease recurrence or progression occurs with these treatments, second-line treatment options include switching to another aromatase inhibitor or a selective estrogen receptor down-regulator. However, he noted that second-line treatment options offer few benefits.

Everolimus is the first and only treatment that boosts the effectiveness of endocrine therapy, significantly extending the time women with advanced breast cancer live without tumor progression.

Campone cited the results of a pivotal Phase III clinical study (Breast Cancer Trials of Oral Everolimus-2), which showed that treatment with everolimus plus the aromatase inhibitor exemestane more than doubled median progression-free survival (PFS) to 7.8 months, compared to 3.2 months with exemestane alone.

Additional analysis showed everolimus plus exemestane extended median PFS to 11.0 months compared to 4.1 months with exemestane alone. 

According to the Department of Health, at least 10,000 cases of breast cancer are reported annually in the Philippines.

Breast cancer is the third leading cause of death in the country and the number one type of cancer among Filipino women. About four out of 10 Filipino women diagnosed with breast cancer die due to the disease.

“We are pleased to bring a highly effective treatment to Filipino women and physicians who are in need of new approaches in the battle against breast cancer,” said Bibiane Fontejon, Oncology Business Unit head of Novartis Healthcare Philippines.

The once-daily tablet everolimus is also approved for the treatment of adult patients with advanced renal cell carcinoma (the most common type of kidney cancer) whose disease has progressed on or after treatment with another targeted therapy, anti-VEGF therapy, as well as adult patients with advanced neuroendocrine tumors (NET) of gastrointestinal, lung or pancreatic origin.