A PILL which is taken twice a day for the most common type of advanced breast cancer has been approved on the NHS in what scientists say is a “landmark moment”.
Up to 3,000 women every year could benefit from oral medication capivasertib for hormone receptor (HR)-positive HER2-negative breast cancer – specifically if the cancer has certain genetic mutations and has spread.
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The drug, which is also known as Truqap and made by AstraZeneca, works by blocking the action of an abnormal protein molecule AKT that causes cancer cells to multiply.
It therefore helps to slow or stop the spread of cancer cells.
Results from a clinical trial showed capivasertib, plus hormone therapy fulvestrant, increased the time before the cancer got worse by around 4.2 months compared with a placebo plus fulvestrant – from 3.1 months to 7.3 months.
The new drug is suitable for patients’ tumours with mutations or alterations in the PIK3CA, AKT1 or PTEN genes, which are found in approximately half of patients with HR-positive breast cancer.
Read more on breast cancer
Professor Nicholas Turner, from the ICR and the Royal Marsden NHS Foundation Trust, led a major trial into the drug.
He said: “This positive Nice (National Institute for Health and Care Excellence) recommendation means that thousands of NHS patients with advanced breast cancer with these specific biomarkers can now receive this innovative targeted treatment to keep their cancer from progressing for longer.
“It’s an immensely rewarding moment to see this drug provide patients with a treatment option and precious extra time with their families.
“It is now crucial that advanced breast cancer patients have their cancer tested to identify those who could benefit from this capivasertib combination.”
Professor Kristian Helin, chief executive of the ICR, said: “This announcement is a triumph that will improve treatment for these patients with the most common type of advanced breast cancer.
“Around half of patients with this kind of breast cancer have mutations in one or more of the genes, and for these patients capivasertib can halt disease progression.
“I’m delighted that access to the drug is being expanded to NHS patients in England and Wales who are in desperate need of better options.”
Claire Rowney, chief executive of Breast Cancer Now, welcomed the approval but said an initial rejection by Nice over uncertainties in the evidence had led to delays.
“This happens too often and urgent action must be taken to ensure the quick approval of breast cancer drugs so they can be made available promptly to those who need them,” she said.
“NHS England must now put in place prompt genetic testing to ensure those eligible receive capivasertib without further delay.
“The Scottish Medicines Consortium must also consider this treatment at pace now, so that we see it made available to all who need it across the UK.”
Spotting signs of breast cancer
Spotting signs of cancer early significantly improves treatment outcomes and survival chances.
The NHS says symptoms of breast cancer in women may include:
- a lump, or swelling in your breast, chest or armpit
- a change in the skin of your breast, such as dimpling (may look like orange peel) or redness (may be harder to see on black or brown skin)
- a change in size or shape of one or both breasts
- nipple discharge (if you are not pregnant or breastfeeding), which may have blood in it
- a change in the shape or look of your nipple, such as it turning inwards (inverted nipple) or a rash on it (may look like eczema)
- pain in your breast or armpit which does not go away – breast pain that comes and goes is usually not a symptom of breast cancer
Symptoms of breast cancer in men may include:
- a lump or swelling in your chest or armpit
- liquid leaking from your nipples (nipple discharge), which may have blood in it
- changes in the size or shape of either side of your chest
- sores or ulcers on your chest
- a change in the shape or look of your nipple, such as it turning inwards (inverted nipple) or a rash on it (may look like eczema)
Carrying out regular checks for symptoms is advised. Find out how below…
How to check your breasts
It is important to regularly check your breasts for any changes. Breast tissue reaches all the way up to your collarbone and across to your armpit, so it’s vital to check these areas too.
If you feel or see any changes in your breast you should always consult your GP.
Charity CoppaFeel! recommends checking your breasts monthly, so you can pick up on any changes quickly.
Breasts do change naturally as part of your monthly menstrual cycle, so you should get to know your breasts, how they feel and what changes they usually go through to know if anything is out of the ordinary.
Five-step check
There is a five-step self exam you can do at home to check for any changes.
Step one: Begin by looking in a mirror, facing it with your arms on your hips and your shoulders straight. You should be looking for any dimpling, puckering, bulging skin, redness, soreness, a rash or changes in the nipple.
Step two: Still looking in the mirror, raise both arms above your head and check for the same changes.
Step three: With your arms still above your head, check for any fluid coming from the nipples. This can include milky, yellow or watery fluid, or blood.
Step four: While lying down use your opposite hand to check each breast. Using a few fingers, keeping them flat and together, go in a small circular motion around your breasts. Make sure you feel the entire breast by going top to bottom in these small circles. It helps to develop a system or pattern to make sure every inch is covered. Use light pressure for the skin and tissue just beneath, medium pressure for the tissue in the middle of your breasts, and firm pressure to feel the tissue at the back, feeling down to your ribcage.
Step five: Feel your breasts while either standing or sitting, using the same small circular motions.
