Combination therapy for Metastatic Cancer – Key Things to Know

When Breast Cancer spreads beyond breasts to other organs, mostly lungs, bones, liver or brain, it is called Metastatic Breast Cancer. Even though cancer spreads to different organs, it is considered as breast cancer and is treated with breast cancer drugs, irrespective of the organ affected.

If the cancer is confined to breasts or nearby lymph nodes, it is easy to cure. However, when it spreads to different organs, it gets more complex. But, it can still be treated.


Breast Cancer Care or the treatment depends on factors like – characteristics of cancer cells, symptoms, where has the cancer spread and past breast cancer treatments.

  • Hormone receptor-positive cancer is treated with hormone therapy as the first treatment
  • HER2-positive cancer is treated with anti-HER2 drugs like trastuzumab(Herceptin)

In order to ease the symptoms or slow down the growth of tumors, chemotherapy and radiation therapy can be opted for. However, these therapies have certain side effects.

Following are certain therapies that can be taken to combat cancer.

Breast cancer care hangtags

Hormone Therapy

The drugs used in Hormone Therapy help to prevent cancer cells from receiving estrogen that is needed by them to grow. Choice of hormone is dependent on menopausal status or other hormone treatments.

A combination of therapies is used to enhance the effect of therapies.

Palbociclib and hormone therapy

Cells multiply through cell division and need enzymes like CDK4 and CDK6. CDK4/6 inhibitors like Palbociclib (France) interrupt the growth of cancer cells. CDK4/6 inhibitorsPalbociclib is used in combination with the hormone therapy for the treatment of hormone receptor-positive, HER2-negative metastatic breast cancer.

Palbociclibalong with Letrozole (an aromatase inhibitor) or Fulvestrant (anti-estrogen drug) can lengthen the time before cancer spreads. The effects are better than Letrozole or Fulvestrantbeing used alone.

Everolimus (Afinitor) and hormone therapy

Use of targeted therapy drugs increases the effect of Hormone Therapy. mTOR (mammalian target of rapamycin) inhibitors are used for this purpose. It has been proved that a combination of Everolimus and the Aromatase inhibitor exemestane can slow down the growth of cancers better than exemestane alone.

Targeted Therapy

For the patients with HER2 Positive Cancer, targeted drugs help in giving relief. Pertuzumab (Perjeta) is an antibody that is used in the targeted therapy and aims at HER2-positive cancer cells. It has been proven through researchers that Pertuzumab in combination with Trastuzumab(another antibody for targeted therapy) and chemotherapy can slow down the growth of HER2-positive metastatic breast cancer. This combination therapy also increases chances of survival that are better than trastuzumab and chemotherapy alone.

Lapatinib combined with chemotherapy

This therapy lengthens the time before cancer spreads. It has better results when compared to chemotherapy alone.

Lapatinib combined with hormone therapy

Lapatinib is combined with aromatase inhibitor Letrozole to lengthen the time before cancer spreads.

Lapatinib combined with trastuzumab

This combination also helps by hindering the spread of cancer through the body. Usage of these drugs leads to certain side effects too. Thus, one should talk to the doctors before starting the medications.


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