Breast Cancer Treatment Breakthroughs and the Role of Exercise

Recent years have witnessed significant advancements in breast cancer treatment, particularly between 2022 and 2025. These developments, coupled with the growing recognition of exercise's role in enhancing treatment efficacy and recovery, offer new hope to patients worldwide.​

Advancements in Breast Cancer Treatment (2022-2025)

1. Targeted Therapy Innovations

• Camizestrant: In February 2025, AstraZeneca announced that its experimental drug, camizestrant, significantly improved survival rates for patients with advanced breast cancer. Administered alongside standard care agents, camizestrant enhanced progression-free survival in hormone receptor-positive, HER2-negative advanced breast cancer patients with specific genetic mutations.

A significant proportion of patients with ER-positive/HER2-negative early breast cancer are considered to have an intermediate/intermediate – high or high risk of recurrence with incurable disease following standard-of-care endocrine therapy, with the risk of recurrence persisting for decades after the initial diagnosis. New endocrine therapy options with greater clinical efficacy are required to address this unmet need. Camizestrant is a ngSERD and complete ER antagonist that has demonstrated encouraging clinical activity in the advanced disease setting, as well as clinical pharmacodynamic activity in the pre-operative setting, and has the potential to improve on current standard-of-care endocrine therapy in early breast cancer. The CAMBRIA-1 and CAMBRIA-2 studies will help to define the role of camizestrant in the early disease setting, in two distinct but overlapping populations of patients at intermediate/intermediate – high or high risk of either early or late disease recurrence. The studies aim to address the clinical unmet need in these populations by reducing the risk of recurrence and death due to metastatic disease.

Hamilton, E. P., Loibl, S., Bachelot, T., Gnant, M., Niikura, N., Park, Y. H., … Mayer, I. A. (2025). CAMBRIA-1 & CAMBRIA-2 phase III trials: camizestrant versus standard endocrine therapy in ER+/HER2– early breast cancer. Future Oncology, 1–12. https://doi.org/10.1080/14796694.2025.2459548

• Elacestrant and Liquid Biopsies: The NHS in England introduced liquid biopsies to detect circulating tumor DNA (ctDNA), specifically the ESR1 mutation. This advancement allows for the administration of elacestrant, an oral medication targeting this mutation, offering a less invasive and more precise treatment option.

In summary, the approval of CDK4/6i represented a significant advancement in the treatment paradigm for ER+/HER2- ABC, supported by robust evidence from phase III trials demonstrating improved PFS and OS outcomes when combined with ET. Key trials have reported mPFS values ranging from 14.8 to 26.7 months and median OS extending up to 53.7 months. Despite their efficacy, challenges such as variable drug response and the development of resistance mechanisms persist, highlighting the need for further research into personalized treatment strategies. Integrating identified biomarkers into clinical practice is crucial for tailoring therapeutic approaches and optimizing patient outcomes. For instance, therapies like alpelisib have demonstrated a mPFS improvement of up to 11 months in patients with PIK3CA mutations. Moreover, the ongoing exploration of alternative therapeutic options for refractory patients underscores the continuous efforts to enhance treatment efficacy. With emerging biomarkers alongside advancements in next-generation CDKi and targeted therapies, there is tangible optimism for the future of ER+/HER2- BC management. Moreover, the use of NGS panel tests utilizing tissue and/or blood has the potential to provide clues for overcoming drug resistance and improve tailored treatment.

Cejalvo Andújar JM, Ayala de la Peña F, Margeli Vila M, Pascual J, Tolosa P, Pages C, Cuenca M, Guerrero Zotano Á. Optimizing therapeutic approaches for HR+/HER2- advanced breast cancer: clinical perspectives on biomarkers and treatment strategies post-CDK4/6 inhibitor progression. Cancer Drug Resist. 2025 Jan 22;8:5. doi: 10.20517/cdr.2024.169. PMID: 39935426; PMCID: PMC11810462.

2. Immunotherapy Breakthroughs

• Nivolumab: There have not yet been any large-scale studies.  However, it's worth monitoring this potential breakthrough.  A significant international clinical trial demonstrated that adding the immunotherapy drug nivolumab to chemotherapy improved breast cancer cure rates by up to 20%. This combination reportedly doubled the number of patients achieving a pathological complete response, indicating no detectable cancer post-treatment.

3. Reevaluating Early-Stage Breast Cancer Treatment

• Emerging research suggests that not all early forms of breast cancer, specifically ductal carcinoma in situ (DCIS), require aggressive treatment. A study led by Dr. Shelley Hwang from Duke Cancer Institute monitored nearly 1,000 women with low-risk DCIS for two years. Findings indicated that those who opted for regular monitoring did not have higher cancer rates compared to those who underwent immediate treatment, paving the way for less invasive management strategies.

Conclusion
There was no statistically significant difference in disease-specific survival between women operated with breast-conserving surgery alone, breast-conserving surgery with radiation treatment, or mastectomy for ductal carcinoma in situ. Given the low absolute risk of disease-specific mortality, these results provide confidence in offering individualized locoregional treatment without fear of compromising survival.

Sabrina M Wang, Yan Li, Amanda Nash, Yi Ren, Samantha M Thomas, Amanda B Francescatti, Anne Barber, Thomas Lynch, Elizabeth S Frank, Lars J Grimm, Alastair M Thompson, Ann H Partridge, Terry Hyslop, E Shelley Hwang, Marc D Ryser, Disease-specific survival outcomes for patients after locoregional treatment for ductal carcinoma in situ: observational cohort study, British Journal of Surgery, Volume 111, Issue 9, September 2024, znae198, https://doi.org/10.1093/bjs/znae198

 The Role of Exercise in Enhancing Treatment and Recovery

Exercise has emerged as a pivotal component in breast cancer treatment and recovery, offering benefits that extend beyond physical health.​

1. Improved Treatment Efficacy

   • Regular physical activity has been linked to enhanced chemotherapy outcomes. A Yale Cancer Center study found that a targeted diet and exercise intervention could improve chemotherapy efficacy for women with breast cancer. Participants who engaged in regular exercise and maintained a healthy diet experienced better treatment outcomes, including higher rates of complete response to chemotherapy. ​medicine.yale.edu

2. Reduced Recurrence and Mortality Rates

   • Consistent exercise has been associated with a lower risk of breast cancer recurrence and mortality. A study highlighted by the National Cancer Institute found that women who engaged in regular physical activity before and after diagnosis had improved survival rates compared to inactive individuals. ​cancer.gov

3. Enhanced Quality of Life

   • Physical activity plays a crucial role in improving the quality of life for breast cancer patients. Engaging in regular exercise has been shown to alleviate treatment-related side effects, reduce fatigue, and enhance overall well-being. ​wcrf.org

4. Mechanisms Behind Exercise Benefits

   • Exercise influences various biological mechanisms that may enhance cancer treatment efficacy. These include improved immune function, reduced inflammation, and better regulation of hormones associated with cancer progression. ​pmc.ncbi.nlm.nih.gov

Integrating Exercise into Breast Cancer Care

Given the substantial benefits, integrating exercise into breast cancer care protocols is essential.​

• Personalized Exercise Programs: Tailoring exercise regimens to individual patient needs, considering factors like treatment stage, physical fitness, and personal preferences, can maximize benefits.​

• Professional Guidance: Consulting with healthcare professionals, such as oncologists and exercise physiologists, ensures that exercise programs are safe and effective.​

• Supportive Resources: Access to support groups and educational materials can motivate patients to maintain an active lifestyle during and after treatment.​

In conclusion, the period from 2022 to 2025 has seen remarkable advancements in breast cancer treatment, with targeted therapies and immunotherapies leading the charge. Complementing these medical interventions, regular exercise has proven to be a powerful ally, enhancing treatment efficacy, reducing recurrence risks, and improving the overall quality of life for patients. Embracing a holistic approach that combines cutting-edge treatments with lifestyle modifications holds the promise of better outcomes for those affected by breast cancer.​

  References:

https://www.reuters.com/business/healthcare-pharmaceuticals/astrazeneca-therapy-improves-survival-late-stage-breast-cancer-trial-2025-02-26/?utm_source=chatgpt.com

https://www.heraldsun.com.au/subscribe/news/1/?sourceCode=HSWEB_WRE170_a&dest=https%3A%2F%2Fwww.heraldsun.com.au%2Fnews%2Fvictoria%2Fdrug-dramatically-improves-outcomes-for-breast-cancer%2Fnews-story%2Fcf9e75571acce7e33ddc5abc6e8b37de&memtype=anonymous&mode=premium&v21=GROUPA-Segment-1-NOSCORE

https://www.eatingwell.com/habit-to-start-to-reduce-risk-breast-cancer-8725727