Editor's Note: The "2023 Breast Cancer Summer Forum · Northern Salon" was held in Beijing with great fanfare. The conference adhered to the concept of "learning, absorbing, innovating, and improving," carrying forward the salon tradition of "East, South, West, North, Ancient, Modern, Spring, Summer, Autumn, Winter, Male, Female, Young, and Old," and shared the current status and advances in the diagnosis and treatment of breast cancer. At the HER2 Special Session and the "Cure Her" 2023 New Ecology of Oncology Treatment Forum, Professor Jiang Zefei, Chairman of the Conference and from the Chinese People's Liberation Army General Hospital, delivered an exquisite "TED TALK" to kick off the event. Through a captivating narration of the history of HER2 treatment and a splendid portrayal of "patient" scenarios, he told the story of breast cancer transitioning from treatment to cure.
“Women are the sky, and men are the earth. Only when women are well, can men stand tall.” Under the spotlight, Professor Jiang Zefei slowly stepped onto the center stage. In his voice filled with helplessness and regret, what appeared before the audience were alarming statistics – globally, 2.261 million women are diagnosed with breast cancer every year, and in China alone, there are 416,000 new cases of breast cancer patients annually. Breast cancer has become the leading malignant tumor threatening women’s health.
As a soldier, Professor Jiang Zefei is resolute, “People first, life first,” as called for by the Party Central Committee. As a doctor, he deeply feels the weight of his unshirkable responsibility. The “Healthy China 2030 Planning Outline” explicitly requires achieving comprehensive chronic disease management for the entire population across the entire lifecycle by 2030, increasing the overall five-year survival rate of cancer in China by 15%, and raising the five-year survival rate for breast cancer to 80%-90%. We have already embarked on the path to curing breast cancer. In the field of HER2-positive breast cancer, following the direction of anti-HER2 treatment, “Cure Her” is no longer a distant goal.
Tracing the History of HER2-Positive Breast Cancer Treatment Mapping Out a Brand New Anti-HER2 Treatment Blueprint
Throughout the history of targeted therapy for breast cancer, numerous milestones are worth remembering. In 1985, the discovery of the human epidermal growth factor receptor 2 (HER2) gene unexpectedly opened the door to potential cures. In 1987, Professor Robert A. Weinberg published the significance of HER2 in breast cancer in the journal “Science,” which became one of the pivotal discoveries that changed the history of breast cancer treatment. As the wheel of history turned forward, scientists discovered that controlling the HER2 gene could prolong the lives of breast cancer patients. After confirming HER2 as a therapeutic target, scientists began seeking methods to block HER2. After years of research, trastuzumab (H) emerged, marking a milestone event in anti-HER2 therapy.
Over the past 20 years since the emergence of trastuzumab, a series of research results such as HERA, Newsphere, TRAIN-2, CLEOPATRA, APHINITY, KATHERINE, EMILIA, and others have been successively published. After going through the era of H monotherapy, the era of tyrosine kinase inhibitors (TKIs), and the era of trastuzumab plus pertuzumab (PH) dual targeting, the treatment of HER2-positive breast cancer has entered the era of antibody-drug conjugates (ADCs). The new landscape of anti-HER2 drug therapy is now incomparable to the past. Professor Jiang Zefei feels gratified: the survival rate of HER2-positive advanced breast cancer patients has greatly improved. After timely and scientific treatment, the median survival period of most advanced patients now exceeds 5 years, with a 10-year overall survival rate of over 90% for small tumor patients in the APT study. Breast cancer is gradually transitioning to chronic disease management, achieving clinical cure, which is no longer a dream.
Anti-HER2 Therapy at the Forefront of the World The Advancement of Breast Cancer Diagnosis and Treatment in China from “Treatment” to “Cure”
As the treatment options for breast cancer become increasingly diverse, the level of breast cancer treatment in China has also greatly improved. The differences in the treatment of breast cancer patients between China and the United States are gradually changing. On June 30, 2023, the Chinese Society of Clinical Oncology (CSCO) Breast Cancer Database Collaboration Group published a research report in the online edition of the Journal of the American Medical Association (JAMA Network Open, IF=13.8). This study, using large databases from China and the United States, compared the differences and trends in the treatment of early breast cancer patients between China and the United States from 2011 to 2021. The results showed that the proportion of HER2-positive breast cancer in China is relatively high, and the proportion of precise anti-HER2 treatment has rapidly increased, surpassing the United States in 2017 and reaching world-leading levels.
Less time as a patient, More time as oneself, Making breast cancer patients “more sunny and at ease
The diagnosis and treatment process for cancer patients is cumbersome and burdensome, greatly affecting the normal lives of patients and their families. Currently, as the number of cancer patients in China continues to increase, it is urgent to improve the quality of life of cancer patients, optimize their treatment experience, and achieve the goal of chronic disease management for breast cancer. From the perspective of medical development, medical treatment has gradually shifted from a disease-oriented model to a patient-centered model, emphasizing the core value of patients in the diagnosis and treatment process. It is the unchanging initial intention of medical practitioners to strive for the opportunity for “clinical cure” for each patient. Policymakers also increasingly emphasize “improving patient experience” to ensure patient satisfaction. In this context, innovative formulations have become the new future in the field of oncology. In the field of anti-HER2 therapy, the newly developed subcutaneous formulation of trastuzumab greatly reduces the hospitalization time for patients, reduces the burden of family caregiving, and alleviates patients’ fear of traditional intravenous medication, helping patients seek medical care “anytime, anywhere, as they wish,” and leading them back to normal life.
As the long-term survival of breast cancer patients becomes a reality, as breast cancer patients are no longer afraid of treatment, as breast cancer patients forget that they are patients, when millions of patients experience “her cure and ease”… At that time, the cure for breast cancer will truly be achieved. Facing a bright future, Professor Jiang Zefei generously calls for action: “Her cure, hopes to achieve physical, psychological, and social functional healing for patients through more effective treatment, allowing patients to return to their families, return to society, and embrace a beautiful life!”
