Targeted therapy transforms breast and prostate cancer treatment: experts

The conference titled "New Treatment Directions in Breast Cancer and Prostate Cancer," chaired this month by Professor Le Van Quang, Director of Vietnam National Cancer Hospital, and Associate Professor, Le Dinh Khanh, President of the Vietnam Association of Urology and Nephrology, featured presentations by two international experts and leading Vietnamese experts in breast cancer and urology.

The event attracted over 150 medical professionals, who attended both in person and online.

Professor, PhD. Le Van Quang gives the opening speech at the conference. Photo courtesy of AstraZeneca Vietnam

In the era of precision medicine, targeted therapies are proving effective against many different types of cancer.

PARP inhibitors have been approved in several countries for multiple indications in ovarian, breast, prostate, and pancreatic cancers, offering significant benefits for patients.

These therapies can help extend life expectancy, improve disease-free survival rates, and enhance overall patient survival.

In Vietnam, breast cancer is the most common cancer in women, with more than 24,000 new patients and more than 10,000 deaths annually. Data show that nearly 70% of cases are diagnosed in the early stages.

However, 20–30% of patients will progress or metastasize, especially in high-risk patient groups with clinical characteristics such as young age, large tumors, positive lymph nodes, high histological grade, and BRCA1/2 gene mutation.

Among these, the BRCA1/2 gene mutation is associated with specific clinical features, a worse clinical course, and poor treatment outcomes. Therefore, treatment needs to be individualized to improve overall patient survival.

For men, prostate cancer is the 5th most common cancer in Vietnam, with more than 5,800 new patients and 2,800 deaths annually.

Metastatic castration-resistant prostate cancer (mCRPC) is a disease with a poor, heterogeneous prognosis that often leads to death.

The workshop updated the latest clinical data showing the role of PARP inhibitors in 2 patient groups: early-stage breast cancer, HER2 negative, with hereditary BRCA1/2 mutations, and breast cancer.

Metastatic castration-resistant prostate cancer has no indication for chemotherapy.

Emphasizing the importance of BRCA1/2 gene mutation testing in the early-stage breast cancer patients' group, Associate Professor, Phung Thi Huyen, Head of Internal Medicine Department 6, K Hospital, said that testing for BRCA1/2 gene mutations is an important step to help surgeons and internists have a comprehensive patient management plan, including decision-making.

She also mentioned that for patients with early-stage, high-risk breast cancer who have inherited BRCA1/2 gene mutations, are HER2-negative, and have been treated with neoadjuvant or adjuvant chemotherapy, PARP inhibitors are an approved treatment option in Vietnam and are recommended by reputable associations.

Data from the OlympiA study showed that this high-risk patient group using Olaparib significantly prolonged overall survival, and nearly 90% of patients were alive after 4 years of treatment.

To date, OlympiA is the only study with clinical data showing a statistically significant survival improvement in patients with HER2-negative early breast cancer.

The combination of new-generation endocrine therapy and PARP inhibitors from the first step in patients with castration-resistant prostate cancer has been demonstrated through clinical studies, including the PROpel study.

The results showed that the group of patients using this combination had a progression-free survival time of up to more than 2 years, an increase of more than 8 months compared to the comparison group, and the overall survival time of the combination arm was over 42 months.

This effect was consistent across different subgroups, based on HRR mutation status, metastasis status, symptoms, or prior chemotherapy treatment.

Adverse events were all manageable and similar to the side effects of each drug, such as anemia, fatigue, nausea, or high blood pressure.

Associate Professor, Doctor, Senior Lecturer Le Dinh Khanh, Chairman of the Vietnam Urology-Nephrology Association and Chair of the seminar, also commented in the Prostate Cancer Discussion Session.

According to Khanh, in the metastatic castration-resistant prostate cancer stage, although patients still have some treatment options, the outcome remains poor, and less than 50% of patients can receive further treatment at step 2.

This situation highlights the need for aggressive treatment and effective selection at step 1.

The results of the study support the combination of targeted therapy and new-generation endocrine drugs as the new standard of care for these patients.

Associate Professor Le Dinh Khanh, speaks during the prostate cancer discussion session. Photo courtesy of AstraZeneca Vietnam

Accordingly, Atul Tandon, General Director of AstraZeneca Vietnam, is committed to partnering with Vietnam's healthcare system for sustainable development and bringing life-changing treatments to the people and community.

He said that over the past 30 years, AstraZeneca has always strived to provide people with leading therapies for respiratory, digestive, cardiovascular, renal, and metabolic diseases, with a particular focus on oncology.

Through ongoing collaboration with hospitals and medical organizations, they have positively impacted the lives of millions of patients, including those battling breast and prostate cancer.

"Embracing advancements in science in breast and prostate cancers, AstraZeneca is dedicated to achieving significant improvements in treatment outcomes. Our ultimate ambition is to end cancer as a cause of death," said Atul.

Delegates congratulated the indications of the two studies that have been officially approved in Vietnam. Photo courtesy of AstraZeneca Vietnam

In addition to seminar programs connecting foreign speakers with leading Vietnamese experts, AstraZeneca has partnered with hospitals to provide high-quality molecular biology tests (HRD, HRR, and BRCA) for over 1,300 patients and support the establishment of genetic counseling units.

To alleviate the financial burden of treatment costs, AstraZeneca is working closely with hospitals and the Ministry of Health to gain approval for drug support programs.

After each cycle of self-funded treatment, patients can receive free support for the next one to two cycles of treatment, making targeted therapies accessible to more cancer patients in Vietnam.