Metastatic breast cancer: a review of current and novel pharmacotherapy

Despite improvements in screening and treatment, it is estimated that 1 in 8 women will develop breast cancer in their lifetime, and in 2010, it was expected that this would result in an estimated 39,000 deaths and over 207,000 newly diagnosed cases. The median survival for metastatic breast cancer (MBC) is approximately 18 to 30 months. Except for rare cases, MBC is not considered curable. Thus, therapy focuses on maintaining quality of life, delaying disease progression, and prolonging survival. Modern treatment, targeting tumor biology, is expected to yield the best results with the least toxicity. It is recommended that chemotherapy be reserved for patients in visceral crisis, or those with rapidly progressive disease. With the exception of fulvestrant, there have been few advances in treatment of hormone-sensitive disease, as most research has focused on the development of antineoplastic agents and agents that specifically target growth factors or growth factor receptors. Despite advances in these areas, treatment of MBC hinges on multifarious factors and numerous unanswered questions about therapy linger. Agents that are highly active in heavily pretreated patients are needed to optimize outcomes in patients with metastatic disease. This article reviews current and novel treatment options for MBC. [PUBLICATION ABSTRACT]