A new pill offers hope for advanced breast cancer

Breast cancer is one of the most common cancers in the world, and it often relies on the hormone estrogen to grow. Many treatments for breast cancer aim to block or remove this hormone, especially for a type called estrogen receptor (ER)-positive breast cancer. But what happens when the cancer becomes resistant to these treatments? Exciting research is now showing how new pills, called selective estrogen receptor degraders (SERDs), and a special new medicine named vepdegestrant, are changing the game for patients who need better options.

How breast cancer is usually treated

Most breast cancers are either ER-positive, meaning they need estrogen to grow, or HER2-positive, meaning they have extra copies of the HER2 gene. For ER-positive, HER2-negative breast cancer, doctors often use medicines that block estrogen or stop the body from making it. These include drugs like tamoxifen and aromatase inhibitors. Another medicine, called fulvestrant, works by breaking down the estrogen receptor, but it is given as a shot and sometimes doesn’t work if the cancer has certain mutations.

The challenge of ESR1 mutations

Some breast cancers develop changes in a gene called ESR1. These changes, or mutations, make it harder for regular hormone-blocking medicines to work. According to a study by Turner and colleagues, patients with these mutations often do not live as long on standard treatments (learn more about ESR1 mutations). This is a big problem, so scientists have been searching for new ways to treat these tough cancers.

Oral SERDs: A new kind of medicine

Recently, a new group of medicines called oral SERDs has been developed. These are pills that can be swallowed instead of injected. They work by attaching to the estrogen receptor and helping the body break it down and remove it. One of these, elacestrant, was shown in the EMERALD trial to help patients with ESR1 mutations live longer than with older hormone therapies (EMERALD trial findings). Other oral SERDs like camizestrant and imlunestrant are also being studied for their ability to help patients with advanced breast cancer.

Vepdegestrant: A new way to target estrogen receptors

Now, there is even more hope with a new medicine called vepdegestrant. This drug is a type of "PROTAC," which stands for proteolysis-targeting chimera. That’s a fancy way of saying it helps the body destroy estrogen receptors directly and efficiently. In a recent study in The New England Journal of Medicine, vepdegestrant showed promising results in patients with advanced ER-positive, HER2-negative breast cancer who had ESR1 mutations (vepdegestrant study). Patients taking this medicine had better outcomes than those on older treatments like fulvestrant.

What it means for patients

For people with advanced ER-positive, HER2-negative breast cancer, especially those with ESR1 mutations, these new medicines could mean more time with their families and a better quality of life. Pills are often easier and more comfortable to take than injections, and destroying the estrogen receptor in new ways might help even when other treatments have stopped working.

What’s next for breast cancer treatment?

Doctors and scientists are still figuring out which of these new medicines should be used first and which ones work best together. Some patients might benefit from starting with an oral SERD, while others might do better on vepdegestrant if their cancer has certain mutations. Future research aims to make these choices clearer for patients and their doctors, and health AI tools like those discussed in this SlothMD article about cancer care and AI may soon help doctors personalize treatment even more.

The role of health AI in breast cancer care

As scientists learn more about genes like ESR1 and how cancer changes over time, they are using health AI to look for patterns and predict which treatments will work best. Tools that use health AI can help track how well patients do on different medicines, similar to how AI helps with mental wellness and mood tracking as explained in this SlothMD guide to health AI and mood tracking. By combining new medicines and smart technology, the future of breast cancer care looks brighter for everyone.

New discoveries like vepdegestrant offer hope to patients and families facing advanced breast cancer. Ongoing research and smart health AI tools, like those featured on SlothMD, are helping to find the right medicines for the right people. This means that even when cancer seems tough, there are new reasons to be hopeful.