How a fierce mindset allows us to rewrite breast cancer history

One of the first writings about cancer dates back to 2500 BC by Imhotep, an Egyptian physician who described a patient with a “bulging mass in the breast,” which we now call breast cancer. Unfortunately, he also wrote that there was no treatment for the patient.[i] It wasn’t until centuries later – the mid-20th century – that we started making significant progress against cancer, with each consecutive innovation building upon the other. The exceptional progress made in recent years now means that the modern-day Imhotep would have several options to treat his patients, providing hope. 

 Standing on the Shoulders of Giants

In years past, breast cancer treatment was brutal and failed to prioritize a patient’s quality of life. With limited options available, women diagnosed with breast cancer were subject to radical, mutilating mastectomies. Although what followed next was less physically intrusive than surgery, it was equally harrowing and still pushed patients to their limits. In the early days, chemotherapy was a cocktail of potent drugs that would harm both cancer and healthy cells, leaving patients ill.

About thirty years ago, an event happened that revolutionized breast cancer treatment: Dr. Dennis Slamon’s discovery of the HER2 oncogene and receptor associated with aggressive and deadly breast cancers.[ii],[iii] His breakthrough led to the development of targeted therapies that would vastly improve treatment outcomes and survival for the women (and men) diagnosed with HER2-positive breast cancer.

My dear friend and a visionary leader, José Baselga, was also one of the renowned researchers who helped develop and test targeted cancer treatments, such as a monoclonal antibody targeting HER2, which has positively impacted the lives of countless patients and their families.

HER2 became a guiding light for developing other biomarkers in breast cancer, showing us what can be achieved with targeted therapies. The days of mutilating surgeries and devastating chemotherapy thankfully receded as treatment became more precise and targeted, reducing the risk of severe side effects while improving survival.[iv],[v]

Never Complacent: Continuing the Revolution and Becoming Cancer’s Fiercest Opponent

Despite the phenomenal progress in this field, some patients with HER2-positive early-stage breast cancer still develop metastatic disease. The 5-year survival rate is less than 30% in the metastatic setting.[vi] Cancer remains a formidable enemy that must be attacked from every angle to achieve success for every patient.

At AstraZeneca, we are not settling for the standard of care – in breast cancer or other cancers. I am immensely proud of AstraZeneca’s great legacy and leadership in breast cancer and our refusal to settle for marginal improvements. We are at the forefront of a revolution to redefine breast cancer care, with the bold ambition to one day eliminate this devastating disease as a cause of death – even the first glimmers of hope to cure metastatic disease.

We are exploring new treatments and combinations in a range of resistant cancers, from breast cancer to non-small cell lung cancer (NSCLC) and many others, and simultaneously targeting multiple biological pathways and the immune system. Through this relentless quest for innovation, we have created one of the most diverse oncology portfolios in the industry to tackle cancers with the greatest unmet need.

While new druggable biomarkers were being discovered, enormous progress was made on the next generation of cancer treatments – with the front-runners being antibody-drug conjugates (ADCs), which can directly deliver cancer-killing drugs into the cancer cells and limit damage to healthy cells.[vii] These ADCs can be tailored to target the known oncogenes, including those associated with some of the hardest-to-treat tumor types.[viii] It really feels like we are well on the road to a revolution in cancer care. It is both humbling and exciting to be working alongside such brilliant and dedicated colleagues on this mission. Through this progress, I have learned that, above all, we must adopt a fierce mindset to break through and become cancer’s fiercest opponent. We are rewriting breast cancer history and reshaping the cancer care ecosystem before our eyes.

Growth Through Innovation: The Next Chapter

Most importantly, patients are at the center of it all. Thousands upon thousands of women and men with breast cancer have bravely participated in clinical trials that have produced a wealth of data and information that guides breast cancer treatment today. They are the real heroes helping us to rewrite breast cancer textbooks, drive adoption of new standards of care, and speed toward the future.

We’ve come a long way since the days of Imhotep and his patient with breast cancer. With several advances in this area in recent years, we are truly at an inflection point. Today, we have options that offer the possibility of personalized cancer care so that cure can one day be a reality for every patient.

[i] National Cancer Institute. Targeted Cancer Therapies. Available online. Accessed September 2021.

[ii] American Cancer Society. Targeted Drug Therapy for Breast Cancer. Available online. Accessed September 2021.

[iii] Cancer.Net. Breast Cancer - Metastatic: Statistics. Available online. Accessed September 2021.

[iv] Peters C, Brown S. Antibody-drug conjugates as novel anti-cancer chemotherapeutics. Biosci Rep. 2015;35(4):e00225.

[v] Criscitiello et al. Antibody–drug conjugates in solid tumors: a look into novel targets. J Hematol Oncol. 2021;14:20.

[vi] Mukherjee S. The Emperor of All Maladies: A Biography of Cancer. New York, NY: SCRIBNER; 2010.

[vii] Slamon DJ, Clark GM, Wong SG, et al. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235(4785):177-182.

[viii] Slamon DJ, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science. 1989;244:707-712.