Targeted therapies in combination with specific chemo drugs are proving to be the future for the management of patients with breast cancer which has overtaken cervical cancer cases in terms of incidence.

There are several newer therapies, to improve overall survival rate with fewer side effects. These novel drugs constitute over 70 per cent of the overall breast cancer treatment cost. Now oncologists are keen to drive the need for early detection to make the treatment far more economical for the patient, Dr Padma Kamineni, consultant, breast cancer, Healthcare Global Enterprises told Pharmabiz in an email interaction.

Despite the advanced drugs, oncologists are looking at the Oncolytic vaccines from the herpes virus and the BCG vaccine. All other drugs in the pipeline are only experimental., said Dr Anthony Pais, breast surgeon, professor and senior consultant, head of the Breast Unit and Women's Oncology, Mazumdar Shaw Cancer Centre, Narayana Hrudayalaya Health City.

Latest drugs effective to control breast cancer in India are HER2 targeted therapies trastuzumab(Herceptin), lapatinib (Tykerb), pertuzumab, mammalian target of rapamycin (mTOR) inhibitor everolimus, novel agents like non taxane- microtubule inhibitors Eribulin and epothilone-B analogue Ixabepilone. Endocrine therapies have also proven its benefits in ER, PR positive patients. Endocrine therapies include tamoxifen, letrozole, anastrozole, exemestane and fulvestrant. The global pharma have been the drug innovators and there are now several Indian companies engaged in its production.

According to Dr Ganesha Dev Vashishta, chief medical oncologist, BGS Global Hospitals, most of the newer drugs are specific, effective and less toxic compared to earlier versions. It is the drug costs which constitute 60-80 per cent of the overall treatment expense in each chemotherapy cycle.

Chemotherapy depends on the characteristics of the disease. Oncologists estimate cost of chemotherapy per cycle to vary from Rs.3,000 to Rs.10,000 for patients in under developed countries. It is Rs.1.5 lakh at standard centres in India. Cost of Herceptin in Her-2 positive cases is around Rs.7 lakh for one year. Cost of II line and III line chemotherapy is Rs.1 to Rs.2 lakh per injection. Therefore average cost of treatment for breast cancer could vary between Rs.2 lakh to 20 lakh.

The latest Lancet reports that India is facing a breast cancer epidemic. The number of new is about 115,000 per year which is expected to be 250,000 new cases annually by 2015.

During the annual month-long breast cancer awareness month observed from October 1-31, 2012, oncologists are working ways to handle the rise in the number of breast cancer cases.

The treatment involves a combination of surgery, radiotherapy, chemotherapy depending upon the type, stage of cancer and age of patient. Better treatments mean that more people are now living long and full lives after breast cancer. The five year survival for breast cancer in the western countries is about 85-90 per cent. So, the outlook is actually reassuring provided the cancer is detected at an early stage, said Dr Archana Shetty, consultant oncoplastic breast surgeon, Narayana Hrudayalaya Hospitals, Bangalore.