When you hear “cancer,” what do you think? Endless doctors’ appointments and treatments with needles and tubes. Patients who had to shave their heads and thin bodies due to the chemotherapy. Maybe even commercials and social media posts asking for donations and telling stories of affected families. No matter what you picture, the word “cancer” evokes fear, sadness, anger, and, to those undiagnosed, grief.

According to the American Cancer Society, half of men and one-third of women in the United States will be diagnosed with cancer within their lifetime. Unlike other diseases, cancer cannot be vaccinated for or prevented by keeping your household clean; it comes from within. Our cells have a natural lifecycle, which includes a shut-off switch to remove old, damaged, or diseased cells. When the shut-off doesn’t work, the cell grows out of control, never dying and continuously multiplying, even if it hurts the person it came from.

There are many causes of cancer, ranging from lifestyle, genetics, and exposure to cancer-causing chemicals. No matter the cause, the results are the same: the genes for the cell shut-off switch are broken, and the cell becomes cancerous. Researchers can identify different types of cancers based on which genes have been broken, which makes different specific cancer cells, even for cancers of the same kind, like leukemia or prostate. Thanks to all these advances in genetics and cancer research, one kind of cancer that has become the most infamous is still being researched for new treatments. One new drug may provide a new chance to fight this cancer and improve the lives of those afflicted.

One of the most infamous cancers is breast cancer. It has affected countless lives and has become the biggest fear for many women. Hundreds of thousands of women in the US alone will be diagnosed with breast cancer, and about 50,000 women with breast cancer will succumb to the disease. Out of all cancers that affect women, breast cancer accounts for one-third of them. The presence of this disease has sparked fundraisers, organizations, and entire institutions dedicated to the study and development of treatments for this disease. While much progress has been made in treating breast cancer, one problem has remained: metastatic breast cancer.

When a cell becomes cancerous, it grows and multiplies where it started. So, a breast cancer cell will create tumors in the breast. However, tumors can get close enough to blood vessels for some cells to break off and enter the bloodstream. These loose cancer cells will circulate throughout the body until they anchor in a random spot. The cancer cell begins multiplying and creating a new tumor in the new location. This is known as metastasis and it’s how cancer cells can spread throughout the body.

For breast cancer, it frequently metastasizes in the lungs, liver, and bone. These tumors can be dealt with thanks to modern treatments to improve the patient's outcomes. However, the trade-off is that there has been a rise in breast cancer metastasizing in the brain, with estimates that one-third of metastatic breast cancer patients will develop brain tumors. The outcome for these scenarios is grim as the patients suffer a significant loss in cognitive functions.

There are treatments for breast cancer in the brain, like surgery, radiation therapy, and chemotherapy, but there have also been some challenges. The treatments can be toxic for the patient, the tumors can have cancer cells that are slightly off from each other that the treatment doesn’t work for the entire tumor, and the brain has a special shield that prevents some chemotherapies from reaching the brain. This is known as the blood-brain barrier, a very dense and selective membrane that protects the brain from anything that could pose a threat. Not many drugs can cross this barrier as it is flagged as a threat, but one new treatment has shown that it can cross the barrier and reach breast cancer tumors in the brain.

Anlotinib is a new drug that stops an enzyme known as tyrosine kinase from working and interacts with receptors on the cell that control its growth and division. It can control multiple cellular pathways cancer cells use to survive, and it can also cross the blood-brain barrier. To see how well it fared in patients, a case study reported the results of giving anlotinib as part of treatment for a woman with breast cancer in her brain.

The woman, aged 57, received her first round of chemotherapy, which showed no effect on the metastatic breast cancer in her brain. The second round of treatment included radiation alongside chemotherapy, which also showed no impact. The woman also began experiencing side effects such as nausea and diarrhea from the medications, but also dizziness due to the growing tumors. For the third round, anlotinib was given along with two other drugs. The woman had mild symptoms of diarrhea, which was easy to treat, but more than that, her tumors began to shrink! Anlotinib was able to disturb the tumors and prevent their continued growth with no significant side effects.

Unfortunately, the case study could not follow up with the woman due to the COVID-19 pandemic, but their results show promise. With more studies and trials, anlotinib could become the next big name in chemotherapies that can give breast cancer patients the relief that they need. It may also become their new savior.

References

Key Statistics for Breast Cancer. American Cancer Society. American Cancer Society, January 17, 2024.
Zhang, Q., Yan, X., Tian, T. L., & Wu, X. Case Report: Outcome of Anlotinib Treatment in Breast Cancer Patient with Brain Metastases. Frontiers in Pharmacology.