Dr Rugo on Managing Treatment-Limiting Toxicities in Breast Cancer

Hope S. Rugo, MD, Winterhof Family Endowed Professorship in Breast Cancer, director of Breast Oncology and Clinical Trials Education at UCSF, discusses the critical importance of balancing the benefits of treatments with the management of toxicities within the breast cancer treatment paradigm.

Unprecedented advances in the realms of breast cancer have led the integration of novel classes of drugs and significant improvements in patient outcomes, Rugo explains. Still, more advanced treatment is associated with an increase in treatment-related toxicities, which Rugo highlights as a critical, persisting need within this space.

The mechanisms used to address these toxicities vary in relation to the patient's disease state and their overall condition, Rugo says. The ultimate goal with any treatment is to maintain a patient’s quality of life without compromising treatment outcomes, she adds

Rugo notes that the primary goal for patients in the metastatic setting is to ensure effective treatments are tolerated over extended periods of time, as patients often undergo prolonged therapy. Rugo stresses that it is essential to monitor and manage cumulative toxicities in order to maintain a good quality of life for patients. This involves a detailed assessment of each patient's tolerance to treatment and the implementation of strategies to mitigate adverse effects.

For early-stage breast cancer, the emphasis shifts slightly to balancing the immediate benefits of treatment against potential long-term risks. Rugo points out that understanding whether treatment-related toxicities are short-lived or could have long-term implications is crucial.

Rugo emphasizes the importance of continuous monitoring and supportive care strategies to ameliorate treatment-limiting toxicities in both the early and metastatic settings. This approach ensures that patients not only live longer but also maintain the best possible quality of life, she explains. As breast cancer treatments continue to evolve, the strategies for managing their associated toxicities must also be improved, she concludes.