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    Your Treatment Options for Advanced Breast Cancer

    Chemotherapy continued...

    "Our aim is to keep the cancer under control for as long as possible with as few side effects as possible," says Virginia Borges, MD, of the University of Colorado-Denver School of Medicine.

    Unless you have an urgent condition, like serious liver problems or trouble breathing, you'll probably get one drug at a time. "A combination of drugs will get you a faster response, but not one that lasts longer," Borges says.

    There are several chemo drugs your doctor may choose from, depending on your particular case. Some are pills. Others you get through an IV tube in your arm. Talk with your doctor about what you prefer.

    Hormonal Therapy

    If your cancer is fueled by hormones such as estrogen, you may need to take hormonal therapy. You and your doctor might choose from various types of these drugs. They can lower the amount of estrogen your body makes so it's not available to fuel your breast cancer.

    There are different types of hormonal treatments for breast cancer:

    Tamoxifen and toremifene (Fareston) block estrogen from stimulating cancer cell growth. Doctors call these drugs "SERMS," which stands for selective estrogen receptor modulators.

    Anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) stop the body from making estrogen in women who've gone through menopause.

    Fulvestrant (Faslodex) counters estrogen throughout the body, not just in cancer cells. You get it in a shot. It's approved for use in postmenopausal women with advanced breast cancer who've already tried tamoxifen or toremifene.

    Goserelin (Zoladex) and leuprolide (Lupron) stop the ovaries from making estrogen. Doctors may consider these meds, along with other hormone drugs, in women who have not yet been through menopause. After stopping these drugs, the ovaries may or may not make estrogen again.

    Targeted Treatments

    There are drugs that target specific proteins related to cancer.

    Everolimus (Afinitor) targets a protein called mTOR, and palbociclib (Ibrance) goes after a protein called CDK 4/6. They're approved to treat advanced breast cancer in women after menopause if:

    • Their disease is sensitive to (meaning fueled by) estrogen. Doctors call this “ER-positive.” Most breast cancers are ER-positive.
    • Their cancer is not sensitive to the HER2 protein. Your doctor may call this “HER2-negative.” Most breast cancers are HER2-negative.

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