October 2014 Ask the Expert: Research and Treatments for Metastatic Breast Cancer

October 1, 2014

Living with metastaticinfo-icon breast cancer often means changing treatments from time to time. Your personal needs, medicines you’ve had in the past and symptoms and side effects will be taken into account when it’s time to choose what’s next. Knowing your options and what research is in the pipeline can help you have better conversations with your doctor. In the month of October, Living Beyond Breast Cancer expert Katherine Tkackzuk, MD, answered your questions about treatment options for metastatic disease, how to participate in clinicalinfo-icon trials and what research is on the horizon,

Remember: we cannot provide diagnoses, medical consultations or specific treatment recommendations. This service is designed for educational and informational purposes only. The information is general in nature. For specific healthcare questions or concerns, consult your healthcare providerinfo-icon because treatment varies with individual circumstances. The content is not intended in any way to substitute for professional counselinginfo-icon or medical advice


Question: I have stage 4 breast cancer with liver mets. I am currently on Navelbine – with which I had success 2 years ago – and it doesn't seem to be working well this time. My oncologist and I are going to decide in 2 weeks whether to continue this treatment or begin another. I will also be visiting a local, widely-respected cancer hospital for a second opinion. In this age of digital imaging, how important is it to visit an oncologist for his or her opinion in person?

Dr. Tkaczuk: Yes, there is definitely a benefit to getting a second opinion. If you get one, I recommend you try to go to a specialistinfo-icon who is subspecialized in breast cancer and is involved in clinicalinfo-icon trials.

I do also believe there is a benefit from seeing an oncologistinfo-icon in person. Seeing him or her in person gives the oncologist an opportunity to see you personally, assess your clinical symptoms and examine you. These are important factors in overall decision making in medical oncologyinfo-icon.

Question: Do you see any advantage in seeking a third or fourth opinion, or is recommended protocol fairly similar at respected institutions?

Dr. Tcakzuk: I do not see an advantage in third and fourth opinions. I feel that, sometimes, getting more than two opinions, or several opinions, may only delay treatments and not necessarily impact the final recommendations and treatment approach.

Question: I have stage IV breast cancer with mets in my bones. Are there any clinical trials that I can participate in?

Dr. Tcakzuk: Almost certainly yes, but more information about your breast cancer is needed to determine if there are any trials available for you specifically. Eligibility criteriainfo-icon vary for different trials and are based on your past treatments for breast cancer and the estrogeninfo-icon and HER2 status of your cancer, to name a few. Try asking your oncologistinfo-icon if he or she knows of trials you might be eligible for.

Question: My daughter-in-law is 45 years old and has stage 4 triple-negative breast cancer. What are the latest treatments? Carboplatin was already used and put her in complete remission for 10 months, but now it’s back.

Dr. Tcakzuk: Currently there are clinicalinfo-icon trials with PARPinfo-icon inhibitors given with chemotherapyinfo-icon. Eligibility criteriainfo-icon and the study location would have to be reviewed and determined. Ask your daughter-in-law to inquire with her medical oncologistinfo-icon and ask them to check on clinicaltrials.gov to find specific trials that are enrolling.

Question: Are there any clinical trials for metastatic triple-negative breast cancer?

Dr. Tcakzuk: There are many trials for triple-negative breast cancerinfo-icon. The clinicaltrials.gov website is one of the best resources for checking what trials are available. You can use that site to search for trials using the keyword “triple-negative breast cancer.”

Question: What are the benefits of taking BMN 673? Will I lose my hair if I am put on BMN 673?

Dr. Tcakzuk: BMN 673 is a PARP inhibitorinfo-icon. You should speak to the investigatorinfo-icon who offered you the trial studying this therapyinfo-icon about potential side effects. BMN 673 is still investigationalinfo-icon, meaning it is only under study and not yet approved by the FDAinfo-icon.

Question: What is the longest survival time for a person with metastatic breast cancer?

Dr. Tcakzuk: The length of survival with metastaticinfo-icon breast cancer varies widely and depends on many prognostic factors, such as the location in the body, type of breast cancer and response to treatments; however, some patients live for many years with metastatic breast cancer.