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New Breast Cancer Drug, Tested in Austin, 'Really Meaningful' for Treatment Community

Publication: KXAN-TV (NBC, Austin)

A new drug could help tens of thousands of women living with advanced breast cancer manage the disease without the pain of traditional treatments like intravenous chemotherapy.

The U.S. Food and Drug Administration approved the drug alpelisib at the end of May. The therapy, branded Piqray by pharmaceutical company Novartis, saw success in clinical trials, conducted in part at Texas Oncology in Austin.

"This is going to be really meaningful for the breast cancer community," said Dr. Debra Patt, Vice President of Texas Oncology who referred some of her own patients to the trial.

Patients with metastatic hormone receptor positive breast cancer with PIK3CA gene mutation are eligible for the new treatment. It's a specific subset of cancer diagnoses, but Patt said it represents tens of thousands of women diagnosed every year.

Marty Santa Cruz, 59, one of Patt's patients, might be a candidate for alpelisib. The Texas native was first diagnosed with breast cancer in 2016 while living in Boston. The intravenous chemotherapy her doctor prescribed "about did [her] in."

"I couldn't work, I couldn't leave the house for anything other than doctors' appointments, I couldn't even fix myself a meal," she said. "I was down for six months because of this chemo."

After moving to Kingsland a year and a half ago, Santa Cruz made the hour-long drive to Texas Oncology in Austin for her first appointment, where she told Dr. Patt about back pain she'd been experiencing. "She sent me for a bone scan on our first appointment, and it came back as metastatic breast cancer," she said.

"At first it was like hitting a ton of bricks."

Santa Cruz is now on daily medication to manage her cancer. Patt described it to her as a chronic disease, like diabetes, something she's going to live with for the rest of her life. "You just have to manage it," she said.

Cancer treatments in general are moving toward these types of therapies, Patt said, targeted on a molecular level to specific traits of tumors.

Alpelisib can help manage advanced cancer, stopping tumor growth and allowing patients to live normal lives unencumbered by damaging traditional therapies like intravenous chemotherapy. 

Taken in conjunction with a hormone therapy, Novartis reports the drug can nearly double progression-free survival, the period of time a patient can use a treatment without her cancer getting worse, to 11 months, up from 5.7 months with hormone therapy alone.

More than a third of patients in the trial saw their tumors shrink or disappear, the company says. Patt said this is another tool in the treatment toolbox that will hopefully lead to more advancements in the near future.

"I think as oncologists, this is always what we hope for," she said, "and that's why it's so important that we participate in research, so we can help to get there faster."

Santa Cruz doesn't want to think about having to go through intravenous chemotherapy again. She's not sure her body could handle it. The oral treatment she's on now is showing a lot of improvement in a key cancer marker measured through blood tests, but a tumor in her liver keeps growing. Her doctor is looking at new therapy options to combat the growth, and alpelisib may be the next step in keeping her cancer in check.

"I'm excited about it," she said, "and hope my pathology comes back where I can be a candidate for it and try it."

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