What’s exciting in cancer research right now? In this post, I’ll review several of the most interesting cancer research stories that have been in the news this spring.
These are a few of the recent stories that seem to have the greatest potential impact, at least from my perspective, and that I know I’ll want to follow as they develop further.
Stories worth following include a potential new combination treatment for HER2-positive breast cancer, evidence from a large clinical trial of a gene assay that may help reduce unnecessary treatment, and a new study that offers some insights on male breast cancer.
Targeted Therapies: HER2-Positive Breast Cancer
The I-SPY2 trial is an ongoing clinical trial that uses what is called “adaptive” trial design. This innovative approach allows for a variety of potential new cancer drugs to be tested in relatively small numbers of patients before moving them on to larger trials. If a drug “graduates” from the I-SPY2 trial, it’s considered to have a high likelihood of success in a large, randomized phase III clinical trial.
A potential new treatment combination for HER2-positive breast cancer has recently “graduated” from the I-SPY2 trial. Results for this combination were presented at the annual meeting of the American Association for Cancer Research in April.
In the experimental combination, patients received two relatively new targeted treatments–trastuzumab emtansine (Kadcyla) and pertuzumab (Perjeta)–followed by the chemotherapies doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan), and then surgery.
One of the features of the I-SPY2 trial design is that drugs are given prior to surgery–their effectiveness is evaluated in the breast and lymph node tissue subsequently removed in surgery. Positive results prior to surgery are considered to be a good indicator of a better prognosis.
It was reported that patients receiving the experimental regimen had substantially better pre-surgery results than patients who received the standard regimen of trastuzumab (Herceptin) and paclitaxel (Taxol), followed by the same chemotherapies, and then surgery. The experimental combination is also less toxic than the standard treatment combination because it does not include the drug Taxol, which has significant toxicities. The experimental regimen will now move on to a Phase III clinical trial.
Avoiding Unnecessary Treatment: MammaPrint
Last fall, results from a large clinical trial provided additional evidence that women with early stage breast cancer who have a low score on the Oncotype DX test–a 21-gene assay–can safely avoid chemotherapy.
At the AACR annual meeting, results from another large trial of a different assay, MammaPrint, similarly provided evidence that women with a low score on this test also do not need to receive chemotherapy. The results from the randomized, phase III trial–with 5 years of follow-up–showed this to be the case even for individuals considered to be at high risk of recurrence based on commonly used clinical criteria.
For more information on the study, as well as how the MammaPrint test is similar to and different from the Oncotype DX test, see “MammaPrint, Agendia’s Breast Cancer Test is Having a U.S. Moment. Can It Reduce Overtreatment?” by Dr. Elaine Schattner.
Immunotherapy: Benefits for More Cancer Types
The AACR meeting also included reports from several clinical trials on the use of immunotherapy–especially checkpoint inhibitors–to treat a variety of different types of cancer. Checkpoint inhibitors, also called PD-1 inhibitors, act by “removing the brakes” on the immune system.
One study showed that about one-third of metastatic melanoma patients treated with the PD-1 inhibitor nivolumab (Opdivo) were still alive after 5 years, more than double the 5-year survival rate for advanced melanoma with other available treatments.
Results from other clinical trials showed that PD-1 inhibitors could become a new treatment option for patients with metastatic head and neck cancers as well as patients with advanced Merkel cell carcinoma, an aggressive type of skin cancer.
Male Breast Cancer
Because male breast cancer is rare, there have been not been many studies focused on improving our understanding of the disease and how best to treat it. Therefore, treatment for male breast cancer generally is based on what we know about breast cancer in women.
New research presented at the European Breast Cancer Conference has identified some of the characteristics of male breast cancer that may lead to more effective treatment options for patients. Breast cancers in women are usually classified by sub-type and tumor grade. This study found that tumor grade, in particular, was not as relevant in male breast cancer for determining prognosis or treatment. The researchers also found that the distribution of sub-types was different in men, with hormone-receptor positive breast cancer being by far the most common sub-type.
“Additional tests that are well-established in women, including gene-expression profiling, may result in the identification of more accurate prognostic and predictive markers,” said Dr. Carolien van Deurzen, a pathologist specializing in breast cancer quoted in a release from the European Cancer Organization.
New Treatment Approaches for Metastatic Cancer
Early research worth watching this spring includes a new strategy for treating metastatic cancer. This approach involves a novel treatment that, after being injected, finds its way directly to metastases in the lungs and liver and destroys them. A study on the innovative method of delivering a chemotherapy drug directly to tumor cells, while not affecting normal cells in the body, was recently reported in the journal Nature Biotechnology.
The novel experimental treatment has been tested in animal models of triple negative breast cancer, where 50 percent of mice treated with the disease had no trace of cancer after 8 months. As reported by Science, the lead researcher, Mauro Ferrari, a nano medicine expert at Houston Methodist Research Institute, said that is the equivalent of 24 years in humans. Ferrari is quoted as saying this:
If this research bears out in humans and we see even a fraction of this survival time, we are still talking about dramatically extending life for many years.
The treatment has so far been studied only in animal models and its chances of being successful when tested in humans aren’t known at this point. But the treatment is being moved rapidly into clinical testing, with a clinical trial expected to begin next year.
That’s it for this time. If there was another recent cancer research story or article that caught your attention or if you have thoughts on any of what I’ve included, I’d love to hear from you!
Photo by Lisa DeFerrari