A new study mentioned in a recent New York Times article reveals that “the best strategy is to hit tumors with two or more targeted cancer therapies at once.”
How expanding the use of genetic and other scientific data can help us better target and transform patient treatment and cures:
Dr. Laura Esserman, director of UCSF Helen Diller Family Comprehensive Cancer Center’s Breast Care Center is spearheading the development of a clinical trials model designed to accelerate and improve the efficiency with which experimental breast cancer therapies are assessed. The strategy, which involves the use of molecular markers and MRI, utilizes “adaptive design,” in which drugs are assessed over the course of months – rather than decades – and the information used in real time to direct the course of a trial.
The series of studies are known as I-SPY (investigation of serial studies to predict therapeutic response with imaging and molecular analysis) and are being carried out in patients with locally advanced i.e., aggressive – breast cancer. The goals of I-SPY are to establish a clinical trials model that supports the identification of drugs targeting the molecular profiles of aggressive cancers, and to reduce the duration of the drug-assessment process from the current 15 to 20 years down to a few years.
Dr. Esserman’s team presents several findings at ASCO today. One provocative finding shows that large, locally advanced forms of breast cancer often emerge between regular mammogram exams. These “interval” cancers present an important opportunity for doctors and patients to take advantage of neoadjuvant therapies in advance of surgery, with the hope they would be responsive. The other finding is that using molecular markers, UCSF researchers identified a subset of patients who do well regardless of how they respond to neoadjuvant treatment. They also identified a subset with poor prognosis for whom response to neoadjuvant therapy is a good predictor of long term outcome.
Read the press release:
BRCA1 and BRCA2 are genes that increase the risk of hereditary ovarian cancer, as well as hereditary breast cancer. Testing for mutations in the BRCA1 and BRCA2 genes can predict cancer risk, and can now possibly be used to guide treatment and entry into clinical trials. Dr. Mary S. Beattie, Director of UCSF’s Cancer Risk Program, discusses who should have genetic counseling and why.
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