Creating awareness on cancer patient management in the time of COVID-19 pandemic, the Philippine Society of Breast Surgeons (PSBS) is strengthening the importance of continuing education by launching a webinar series in partnership with various companies including Roche (Philippines) Inc. and to provide opportunities related to cancer prevention and early detection.
For its first webinar series, PSBS focused on “Neoadjuvant to adjuvant therapy: A multidisciplinary approach to patient care”, with medical oncologist, Dr. Marcelo Severino B. Imasa, highlighting the clinical decision points in early breast cancer (eBC) treatment.
Neoadjuvant therapy is the treatment given as a first step to shrink a tumor before the main treatment or the adjuvant therapy.
“Neoadjuvant therapy offers several benefits for eBC treatment management, as it enables early response assessment; enhances surgical options; early systemic treatment, which allows early treatment of micro metastases and provides opportunity for pathologic complete response (pCR). This can translate to a longer disease-free survival in certain sub-types,” said Dr. Imasa.
By pCR, it pertains to the lack of all signs of cancer in tissue samples removed during surgery or biopsy after treatment.
For Dr. Imasa, these medical discussions are especially crucial for patients with high- risk HER2-positive eBC. “They should receive neoadjuvant therapy with pertuzumab + trastuzumab and chemotherapy to maximize their chance of achieving a pCR,” he said. Pertuzumab and trastuzumab are targeted therapy drugs used to treat breast cancer.
But he noted that the assessment of residual disease after surgery is a new decision point for adapting adjuvant therapy. “Adjuvant treatment decisions should be based on neoadjuvant response,” he added. “This will include the potential to de-escalate axillary surgery, as this will depend on response to treatment.”
Dr. Imasa’s lecture was followed by a dynamic discussion among a multi-disciplinary panel consisting of Dr. Pierette Y. Kaw, Dr. Eric Perpetou E. Arcilla, Dr. Maria Luisa Tiambeng, Dr. Elizabeth Ann S. Alcazaren, Dr. Kathleen H. Baldivia, Dr. Hannah Acosta, and Dr. Ray B. Malilay, and Dr. Joan S. Tagorda.
Among Asian countries, the Philippines has the most number of breast cancer incidence. It accounts for 15 percent of all new cancer cases in the country for both sexes and eight percent of all cancer deaths.
For patients who wish to consult with regard to the treatment guidelines amid the pandemic, please consult a physician on multidisciplinary team and/or how you can access these treatments if currently taking them.