Molecular testing used to find the best clinical trial for triple
negative breast cancer patients
MD ANDERSON STAFF
A new trial underway at MD Anderson may lead to new therapies for triple negative breast cancer.
Fifteen to 20% of breast cancers are TNBC (i.e., negative for estrogen receptor, progesterone receptor and human epidermal growth factor type 2 receptor) — among the most difficult breast cancers to treat. Typically, only 50% of patients with TNBC respond to neoadjuvant treatment with standard chemotherapy regimens. Until recently, clinicians have had no method to determine which patients will respond well to chemotherapy.
That may soon change, thanks to an innovative clinical trial at MD Anderson called ARTEMIS. Its mission is to determine if molecular testing of patients’ tumors can improve their response to treatment by guiding patients with chemo-sensitive tumors to standard chemotherapy, and those with chemo-insensitive tumors — tumors with biomarkers that predict a poor response to standard chemotherapy — to clinical trials of drugs that target their tumors’ specific molecular drivers.
“We want to try to home in on groups of patients for which targeted drugs may have the greatest effects,” said Stacy Moulder, M.D., associate professor of Breast Medical Oncology and principal investigator of ARTEMIS. “This would be a way to show that targeted drugs can be effective if the correct patient population is identified.”
The initial molecular profiling of the tumors includes a test for chemo-sensitivity developed by W. Fraser Symmans, M.D., professor of Pathology and Laboratory Medicine.
In addition to guiding treatment for patients, the knowledge gained in the ARTEMIS trial will help pharmaceutical companies decide which experimental treatments to pursue in large clinical trials.
“I think this will be one of the first clinical trials to show that precision medicine benefits patients and that targeted therapy has an impact on pathological complete response rates for triple negative breast cancer,” Moulder said.
Read more about ARTEMIS in Oncolog, MD Anderson’s bimonthly report to physicians about the latest advances in cancer care and research.
Ultrasound images from a patient with triple-negative breast cancer who
participated in the ARTEMIS trial show no reduction in tumor size after
initial treatment with doxorubicin (left) but substantial reduction
after treatment with a targeted immunotherapy agent (right). The patient
had only minimal residual cancer at the time of resection.
Images courtesy of Stacy Moulder, M.D.