Breast cancer breakthrough?

Today’s New York Times reported that a new study  found that breast cancer could be organized into four distinct genetic types.  The hope is that the research will lead to more precise treatment for women with breast cancer. Too often, patients are given chemotherapy that doesn’t help or are subjected to other treatments so broad-reaching that their effectiveness is questionable. Targeted therapies are the gold standard.

It’s great news. It’s also refreshing to read about cancer research that doesn’t focus on an imprecise risk factor, or a risk factor that women can’t do anything about (early period, late menopause, number of children, etc). But will this research actually help patients with breast cancer? Of course it takes time for research to be translated into improvements in treatment, and everyone acknowledges this.

What’s less acknowledged is that even ten years from now, it’s easy to assume that this targeted approach to cancer won’t help all patients with the disease.  If customized treatment for breast cancer were available tomorrow, who would benefit?

The millions of women without insurance? Women who are being treated under the Breast and Cervical Cancer Prevention and Treatment Act? Women on Medicaid and disability? Women who are cobbling together treatment plans made up of a variety of different charity care, pay per use and high-deductible  insurance? The lesbian woman who loses her job because she is sick but who isn’t covered under her partner’s insurance?

Or would the women who benefit from this research be primarily those whose husbands have great insurance?

In international HIV research, scientists are often called upon by community stakeholders to come up with a plan for making potential treatments available to those who need them.  For example in a 2010 study of a gel that could be used to prevent HIV, conducted by South African researchers at CAPRISA, activists demanded accountability and a plan for distribution of this medicine if it was shown to be effective.

The company that manufactured the gel granted royalty-free licenses for 1% tenofovir gel to the International Partnership for Microbicides (IPM) and to CONRAD. These  licenses grant the holder the right to manufacture and distribute the product without paying  additional fees to the company that invented the drug.  In turn, CONRAD  granted a  royalty-free license to the South African  Technology Innovation Agency (TIA), meaning that it will be easier for the South African government to produce and distribute the medication at a reasonable cost.

Could breast cancer researchers take the lead from such innovative strides? Could they try to incorporate this approach into the fundamental structure of their research?

Now that would be something to get excited about.

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