Road to a Cure - Dr. Heather Parsons & Dr. Nancy Lin
This is the third stop in our series that will release a new interview on the concept of a CURE every Monday until the beginning of the San Antonio Breast Cancer Symposium in early December. What has struck me the most about this series is that each of these special interviews can feel like an intimate conversation with your smartest friend who also happens to be an oncologist researcher.
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That's exactly what we try to do here at the podcast and this interview will not disappoint. Co-hosts Victoria Goldberg and Dr. Paula Jayne sit down with Dr. Nancy Lin and Dr. Heather Parsons of Dana Farber Cancer Institute
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This special series, Road to a Cure, has been produced by Victoria Goldberg, Paula Jayne, Ellen Landsberger, and Kate Pfitzer.
Join us as we make over 10 stops all over the U.S. (with one stop in Europe) on this Road to a Cure - every Monday until the start of the San Antonio Breast Cancer Symposium in December!
Mentioned in this Episode
A introduction to biomarkers
What are biomarkers and how are biomarkers used to treat cancer? (MD Anderson)
What is circulating tumor DNA (ctDNA) and how is it used to diagnose and manage cancer? (Medline)
Current scientific research on the use of cell-free DNA (cfDNA) within breast cancer
Long-term survival in HER2+ MBC patients: What does the scientific evidence say?
Sytov et al.(2021) Long-Term Non-progression in Metastatic Breast Cancer Beyond 5 Years: Case Series and Review
Wang et al. (2019) Long-Term Survival of De Novo Stage IV Human Epidermal Growth Receptor 2 (HER2) Positive Breast Cancers Treated with HER2-Targeted Therapy
Murthy et al. (2016) Clinical predictors of long-term survival in HER2-positive metastatic breast cancer
Harano et al. (2016) Clinicopathological and surgical factors associated with long-term survival in patients with HER2-positive metastatic breast cancer
Hsieh et al. (2015) Can maintenance trastuzumab be stopped in patients with HER2-positive metastatic breast cancer?
STOP-HER2 trial
Can a subset of patients with HER2+ metastatic breast cancer be cured? PROJECT SUMMARY Because of the development of highly effective HER2-targeted therapies over the past two decades, most patients now diagnosed with stage I-III HER2+ breast cancer (BC) are cured. These therapies have benefitted patients who develop distant recurrence as well as the increasing proportion presenting with de novo HER2+ metastatic breast cancer (MBC). Indeed, a subset of these patients does exceptionally well, remaining on first- line therapy indefinitely without evidence of disease progression. But, for these patients, the usual clinical paradigm is non-curative. Though retrospective studies show some clinical predictors of durable response to anti-HER2 treatments, there are currently no validated, predictive biomarkers. Though patients may have no evidence of disease for years on systemic therapy, there currently is no standard approach for stopping therapy. Tracking minimal residual disease (MRD) in the blood via cell-free DNA (cfDNA) may provide an important approach to optimize treatment in patients with HER2+ MBC and will allow us to explore whether a subset of such patients might be cured of breast cancer. Together with collaborators at the Broad Institute, we have developed and tested an ultrasensitive blood test to detect MRD that involves tracking a large fingerprint of patient-specific tumor mutations in cfDNA. We have applied this assay to patients with both early and advanced BC, showing a strong relationship between an MRD positive test and disease recurrence or progression. We plan to use this novel assay, in conjunction with a retrospective, cross-sectional study and a prospective clinical trial, to define the role of MRD in HER2+ MBC.
Patient-directed resources for brain metastases
MBC Brain Mets . org (a one-stop resource hub for breast cancer patients living with brain metastasis sharing cutting-edge information and resources in a simple format)
Brain Metastases: Symptoms & Diagnosis (breastcancer.org)
Management of Breast Cancer Brain Metastases (2021: Share Cancer Support webinar)
Brain Metastases and Reasons to Be Hopeful (2019: Share, LBBC, and YSC webinar)
Beyond the Breast: How Some Patients Combat Brain Metastases (Cure Magazine)
For peer support, consider joining the Facebook group: Brain Mets in MBC + Christine
Scientific research & recent physician peer-to-peer discussions on brain mets in HER2+ MBC
Brain Metastases in HER2+ MBC: Medical Oncologists talk about screening recommendations (2021, OncLive video)
Best Practices: HER2+ MBC With Brain Mets: Medical Oncologists discuss evolving treatment (2021, Cancer Network video)
Garcia-Alvarez (2021) Brain Metastases in HER2-Positive Breast Cancer: Current and Novel Treatment Strategies