Drug a ‘light at end of tunnel’ for triple negative breast cancer

Young Australian women newly diagnosed with an aggressive form of breast cancer may soon have access to a potentially lifesaving drug that fights cancer and stops it returning.

Young Australian women newly diagnosed with an aggressive form of breast cancer may soon have access to a potentially lifesaving drug that works with the immune system to fight cancer and stop it returning.

Pembrolizumab, sold as Keytruda, is considered a crucial treatment in helping to “return life to normal” for many women diagnosed with deadly early-stage triple negative breast cancer (TNBC).

On Friday the drug was recommended for a federal government subsidy by the Pharmaceutical Benefits Advisory Committee (PBAC) to treat early-stage TNBC in women who meet the criteria. This includes early-stage diagnosis, no previous treatment and tumours 2cm or larger.

It is already available on the Pharmacuetical Benefits Scheme (PBS) for other types of cancer including lung, bowel and kidney cancers and melanoma.

Melbourne medical oncologist Jacqui Thomson was one of many who celebrated the news that the drug had now moved a step closer to being made affordable and accessible to women with TNBC.

Triple negative breast cancer is typically diagnosed in women under 50 years of age. Picture: iStock

Dr Thomson was involved in international randomised clinical trials of the drug in 2018 and said the benefits in favour of those on the drug were “proven and dramatic”.

She said these included examples of the cancer gone after six months of treatment coupled with chemotherapy before surgery and no return of the disease in follow-up investigations.

TNBC is typically diagnosed in women under 50 years of age and has a poor outcome because of limited treatment options. There are about 2500 new cases each year in Australia with a quarter expected to be eligible for Keytruda if it is listed on the PBS.

The drug is first used in combination with chemotherapy before surgery and then on its own for a further six months to help prevent a recurrence.

Dr Thomson, from Peninsula Health, said it offered women with TNBC a light at the end of the tunnel.

“Any treatment that we can provide to this group of patients, because it disproportionately affects younger women, that has now been clearly demonstrated to improve outcomes is extremely exciting and it is wonderful that the government has agreed with this,” Dr Thomson says.

There are about 2500 new cases of TNBC each year in Australia with a quarter expected to be eligible for Keytruda if it is listed on the PBS. Picture: iStock

She says the goal is to treat TNBC before surgery to leave little to no trace of the disease at the time of the operation. She says surgery is required to be “100 per cent certain” of how effective the treatment has been.

Dr Thomson said the impressive results also meant many patients did not require a mastectomy.

Keytruda is a type of immunotherapy called an immune checkpoint inhibitor. These block proteins that stop the immune system from attacking the cancer cells, reducing the risk of the cancer coming back.

On Tuesday advocacy and support group Breast Cancer Network Australia (BCNA) said it welcomed a decision by PBAC to recommend the drug for government subsidy.

Vicki Durston, its director of Policy, Advocacy and Support Services, said in a statement that 40 per cent of those with TNBC will have a recurrence.

“New treatments like Keytruda that reduce this risk are vital at improving outcomes for those who have one of the rarer forms of breast cancer.’ Ms Durston said.

BCNA says it will continue to work with both the pharmaceutical company and government to ensure Keytruda is listed on the PBS a soon as possible.