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Road to a Cure - ADC & SARM

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The podcast Road to a Cure team meets up with renowned hematologist oncologist, Dr. Hope Rugo of USCF's Carol Franc Buck Breast Care Center. Dr. Rugo is also co-director of UCSF's breast cancer clinical trials program. She is also an investigator with the Bay Area's SPORE (Specialized Programs of Research Excellence) on breast cancer. 

The hosts Victoria Goldberg and Dr. Ellen Landsberger take some time to unpack Dr. Rugo's view of what a "cure" looks like for metastatic cancers, the exciting leadership shown with dosing, and a very clear review of the latest treatments and upcoming clinical trials that could help those with both triple-negative and hormone-positive breast cancer.

Dr Rugo is principal investigator for many clinical trials focusing on combining immunotherapy and targeted therapeutics with standard treatment to improve treatment of metastatic breast cancer. Most recently, she was the lead researcher of the ASCENT trial ( cited below) which excited oncologists and patients alike with the improvement in progression-free and overall survival in those treated with the antibody drug conjugate sacituzumab govitecan than with single-agent chemotherapy among patients with metastatic triple-negative breast cancer.

In addition to her leadership in multiple drug trials, Dr Rugo has taken a keen interest in reducing toxicity from treatment of cancer. She participated in the development of scalp cooling to reduce hair loss from chemotherapy and a steroid mouthwash to reduce stomatitis. 

We were not surprised to learn that Dr Rugo is the recipient of multiple awards both for excellence in patient care and education of patients and medical professionals alike. Both Victoria and Ellen learned so much during our interview session and we are excited to share this episode with you. 

What is Triple Negative Breast Cancer (TNBC)?

A subset of breast cancers that is characterized by absence of the hormone receptors estrogen and progesterone and an absence of the protein Human Epidermal Growth Factor (HER2) 

 

Triple-Negative Breast Cancer

Gene Expression Profiling

Gene Expression Profiling for Diagnosis of Triple-Negative Breast Cancer: A Multicenter, Retrospective Cohort Study

Gene expression analysis to detect disseminated tumor cells in the bone marrow of triple-negative breast cancer patients predicts metastatic relapse.

TNBC and Racial Disparities

Treatment for Metastatic Triple Negative Breast Cancer  

Antibody Drug Conjugates (ADC)

Sacituzumab Govitecan is an antibody drug conjugate ( ADC) that was recently approved by the FDA for treatment of metastatic Triple Negative Breast Cancer. This ADC combines a potent chemotherapeutic agent with an antibody that is recognized by a unique cellular protein on the cancer cell that is not expressed on healthy cells, allowing this “smart bomb” to enter the cancer cell and kill it with minimal damage to healthy cells.  

 Immunotherapy

Selective Androgen Receptor Modulators: SARMS 

Scalp Cooling

Scalp Cooling
https://pubmed.ncbi.nlm.nih.gov/28196257/

Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer. Rugo HS, Klein P, Melin SA, et al. JAMA. 2017;317(6):606–614. doi:10.1001

 

Mouthwash to Prevent Stomatitis

Prevention of everolimus/exemestane (EVE/EXE) stomatitis in postmenopausal (PM) women with hormone receptor-positive (HR+) metastatic breast cancer (MBC) using a dexamethasone-based mouthwash (MW): Results of the SWISH trial.

Hope S. Rugo, Lasikas Seneviratne, J. Thaddeus Beck, John A. Glaspy, Julio Antonio Peguero, Timothy J. Pluard, Navneet Dhillon, Leon C. Hwang, Chaitali Singh Nangia, Ingrid A. Mayer, Timothy F. Meiller, Mark Steven Chambers, Ghulam Warsi, Robert William Sweetman, J. Randy Sabo, and Jennifer Keating Litton

Journal of Clinical Oncology 2016 34:15_suppl, 525-525 

 

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