Editor’s Note: Breast cancer remains one of the most significant threats to women’s health. The continuous evolution of treatment strategies reflects the rapid advancement of medical technology. In recent years, precision treatment for breast cancer has become a focal point of research, with accurate target selection and innovative drug development being of paramount importance. At the 2024 Chinese Congress of Holistic Integrative Oncology (CCHIO), Dr. Chunfang Hao from Tianjin Cancer Hospital Airport Hospital delivered a presentation titled "The Significance of Targets in Breast Cancer Diagnosis and Treatment," offering her unique insights on precision treatment. Following the session, Oncology Frontier interviewed Professor Hao, who provided an in-depth discussion on the critical role of target selection, progress in emerging drugs and therapies, and the future directions in breast cancer diagnosis and treatment.

1. Oncology Frontier: How does the importance of target selection manifest in breast cancer precision treatment?

Dr. Chunfang Hao: Target selection is fundamental in breast cancer precision treatment. Targeted therapy represents a significant breakthrough in the field, and for breast cancer patients, precise target selection often determines the success of treatment. Over the years, remarkable advancements have been made in identifying therapeutic targets and developing drugs. For instance, anti-HER2 targeted therapies and endocrine treatments have significantly improved survival rates and clinical benefits.

The importance of target selection lies in several aspects. First, it determines whether a drug can precisely act on tumor cells, thereby achieving targeted therapy. Second, drugs designed for specific targets often yield better efficacy and lower side effects, improving the patient’s quality of life. Lastly, with the emergence of novel targeted drugs, target selection provides more therapeutic options and strategies. This is particularly crucial for the treatment of refractory breast cancer and early-stage high-risk cases, where precise targeting is key to achieving long-term survival or even cure.

Recent breakthroughs, including ADC drugs and PAM pathway inhibitors, have transformed the landscape of breast cancer treatment, influencing or even redefining clinical practice. Similarly, the latest findings in PARP inhibitors for patients with germline BRCA1/2 mutations underscore the importance of genetic testing. These developments highlight the vital role of target selection in breast cancer precision treatment.

Furthermore, new ADC drugs have focused on developing therapies for various targets, such as HER2 and Trop-2. These drugs not only exhibit potent tumor-killing effects but also broaden the scope of targetable cancer cells. As we look toward the future, target selection in breast cancer treatment will become increasingly diverse and precise, bringing extended survival and enhanced quality of life for patients.

Additionally, the field is embracing a new trend—combination therapies involving targeted drugs. For example, combining ADCs with immunotherapy or anti-angiogenic drugs has demonstrated greater efficacy compared to monotherapy. A notable example is the combination of PARP inhibitors, such as fluzoparib, with anti-angiogenic agents, which has shown significant benefits in extending progression-free survival (PFS). We remain optimistic about the future of targeted therapy in breast cancer and anticipate further groundbreaking advancements to bring hope to more patients.

2. Oncology Frontier: What emerging targeted drugs or therapies are currently in breast cancer treatment? How can treatment outcomes and quality of life be balanced for patients?

Dr. Chunfang Hao: Numerous emerging targeted drugs and therapies are revolutionizing breast cancer treatment. Beyond traditional HER2-targeted and endocrine therapies, new agents such as PAM pathway inhibitors, PARP inhibitors, and Trop-2-targeted ADC drugs have achieved groundbreaking results in clinical studies.

Balancing treatment outcomes with quality of life is crucial in breast cancer care. Achieving this balance requires a comprehensive approach that considers not only therapeutic efficacy but also the potential side effects and the overall impact on the patient’s daily life.

Prior to treatment, we conduct thorough evaluations of the patient’s physical condition, psychological state, and social support systems. During treatment, we closely monitor their responses and manage any side effects, making timely adjustments to treatment plans and dosages as necessary. Patient education is another critical component, empowering patients to actively manage their condition and better understand the potential challenges of their treatment.

Additionally, we proactively address potential side effects and adverse reactions. For example, CDK4/6 inhibitors can cause leukopenia and liver or kidney function abnormalities, so we ensure rigorous monitoring and intervention. Similarly, for PAM pathway inhibitors, which may lead to hyperglycemia, we implement blood sugar monitoring and, when needed, use glucose-lowering drugs to mitigate these effects.

Ultimately, achieving a balance between efficacy and quality of life involves careful consideration of multiple factors, including the patient’s specific condition and the properties of the chosen therapy. By doing so, we aim to provide optimal treatment while maintaining the patient’s overall well-being.

3. Oncology Frontier: With the continuous emergence of new targets and drugs, what do you foresee as the future trends in breast cancer diagnosis and treatment?

Dr. Chunfang Hao: Breast cancer treatment has entered a new era of precision-targeted therapies, and this trajectory will undoubtedly expand. Notably, precision treatment strategies are no longer confined to advanced-stage breast cancer but are increasingly being applied to early-stage cases. In current clinical practice, neoadjuvant HER2-targeted therapies and adjuvant intensification strategies have demonstrated remarkable efficacy, significantly improving cure rates for high-risk and refractory breast cancer patients. Looking ahead, drugs such as PI3K inhibitors are likely to drive new breakthroughs in early-stage breast cancer treatment.

In the realm of advanced breast cancer, the successful development of multiple targeted therapies presents a new challenge—optimizing treatment strategies. Each drug may exhibit unique efficacy in specific resistant patient populations. However, given the growing number of targeted drugs, careful consideration of treatment sequences and combination strategies is essential. Our priority will be to ensure patient safety while maximizing therapeutic benefits and minimizing overlapping toxicities.

Dr. Chunfang Hao PhD, Master’s Supervisor Tianjin Cancer Hospital Airport Hospital Director, Breast Medicine Department, Tianjin Cancer Hospital Airport Hospital Member, Breast Cancer Expert Committee, Chinese Society of Clinical Oncology (CSCO) Member, Breast Cancer Committee, China Anti-Cancer Association Member, Science Popularization Committee, China Anti-Cancer Association Standing Member, Breast Specialist Committee, China Female Doctors Association Vice Chair, Youth Committee for Breast Cancer Prevention and Treatment, Beijing Cancer Prevention and Treatment Society Standing Member, Individualized Diagnosis and MDT Committee for Breast Cancer, Beijing Cancer Prevention and Treatment Society Standing Member, Health Management Committee, Beijing Breast Disease Prevention and Treatment Society Member, Oncology Pharmacology Committee, Tianjin Pharmacology Society