Targeted Therapies Show Dramatic Improvements in Breast Cancer Patients with Rare Subtypes
Published
Targeted therapies improve overall outcomes of patients with rare breast cancer subtypes and, in some cases, improve pathologic complete response rates (pCR) and overall survival to rates comparable to those of patients with breast cancer of no special type.
Thomas and her team were able to retrospectively determine the tumor molecular signature and receptor status to classify the response predictive subtype (RPS).
Based on the tumor’s RPS, Thomas said they were able to retrospectively review outcomes for patients with tumors that had received therapies directed at disease RPS vulnerabilities. These include therapies such as immune checkpoint blockades, which harness a patient’s immune system to help fight cancer. For example, patients identified with HER2-positive breast cancer who received HER2-directed therapy had a higher pCR, indicating no tumor at the time of surgery after upfront cancer treatment.
“We found that if you can find the tumor’s Achilles’ heel and attack it, outcomes for these patients are the same as patients with more common tumor types,” Thomas said.
Thomas’ study was also one of the largest cohorts to show that pCR rates for patients with rare tumors more closely match rates in patients with more common subtypes. This information could empower providers to more readily consider targeted therapies for these patients.
Currently, Thomas is looking into potential cross-disciplinary research opportunities to see if results gained from this research could support targeted therapy interventions in patients with other cancers. The ISPY-2 trial is also looking into pharmacological interventions like antibody-drug conjugates to further support breast cancer patients.
“This research proves that we, as medical providers, can get these tumors treated,” Thomas said. “The more we can focus on a personalized medical approach for these patients, the better their overall outcomes will be.”
New research suggests that targeted therapies can be used to manage malignant phyllodes tumors (MPTs), a rare tumor of the breast with aggressive biologic behavior and high recurrence rates.Duke Cancer Institute breast oncology program members Rani Bansal, MD, and Laura Rosenberger, MD, MS, worked together on this research published in JCO Precision Oncology. Bansal is a medical oncologist, and Rosenberger is a surgical oncologist.MPTs are a type of growth that involves fibrous tissue and surface epithelium. Surgery is the primary treatment option for these tumors; however, Bansal and Rosenberger’s research assessed the molecular structure to reveal new possible treatment opportunities.Study participants underwent genomic sequencing, whole-transcriptome sequencing, and immunochemistry to identify pathogenic fusions to determine potential targeted treatment options. Bansal said this revealed that participants showed prolonged benefit from targeted therapy, with some being able to stay on one targeted therapy for longer than one year.While there are currently many drugs with approval from the Food and Drug Administration (FDA) across various tumor types, such as trastuzumab deruxtecan (T-DXd) for HER2-positive or HER2-low tumors, Bansal believes more options will be available soon.“As the treatment landscape for oncology continues to expand, we will see more targeted therapies available for patients, and we can personalize their systemic treatment to their specific cancer,” she said.While surgical resection remains the mainstay for treating MPTs, this research shows further investigation into how to incorporate targeted therapies into treatment plans is warranted. Bansal and Rosenberger are currently looking into clinical trials to continue this examination.“These results will certainly guide clinical trial design and options for those with specific mutations,” Rosenberger said.This research marks an important first step in understanding next-generation sequencing in MPTs and, hopefully, developing more targeted and effective treatment options for patients.“As we continue to collect data on phyllodes tumors I think continuing to investigate this rare tumor group with more samples and correlating with clinical outcomes could lead to potential therapeutic advances,” Bansal said. “This is just the beginning, and our data shows clinical utility for sending next-generation sequencing for these tumors.”
New research suggests that targeted therapies can be used to manage malignant phyllodes tumors (MPTs), a rare tumor of the breast with aggressive biologic behavior and high recurrence rates.Duke Cancer Institute breast oncology program members Rani Bansal, MD, and Laura Rosenberger, MD, MS, worked together on this research published in JCO Precision Oncology. Bansal is a medical oncologist, and Rosenberger is a surgical oncologist.MPTs are a type of growth that involves fibrous tissue and surface epithelium. Surgery is the primary treatment option for these tumors; however, Bansal and Rosenberger’s research assessed the molecular structure to reveal new possible treatment opportunities.Study participants underwent genomic sequencing, whole-transcriptome sequencing, and immunochemistry to identify pathogenic fusions to determine potential targeted treatment options. Bansal said this revealed that participants showed prolonged benefit from targeted therapy, with some being able to stay on one targeted therapy for longer than one year.While there are currently many drugs with approval from the Food and Drug Administration (FDA) across various tumor types, such as trastuzumab deruxtecan (T-DXd) for HER2-positive or HER2-low tumors, Bansal believes more options will be available soon.“As the treatment landscape for oncology continues to expand, we will see more targeted therapies available for patients, and we can personalize their systemic treatment to their specific cancer,” she said.While surgical resection remains the mainstay for treating MPTs, this research shows further investigation into how to incorporate targeted therapies into treatment plans is warranted. Bansal and Rosenberger are currently looking into clinical trials to continue this examination.“These results will certainly guide clinical trial design and options for those with specific mutations,” Rosenberger said.This research marks an important first step in understanding next-generation sequencing in MPTs and, hopefully, developing more targeted and effective treatment options for patients.“As we continue to collect data on phyllodes tumors I think continuing to investigate this rare tumor group with more samples and correlating with clinical outcomes could lead to potential therapeutic advances,” Bansal said. “This is just the beginning, and our data shows clinical utility for sending next-generation sequencing for these tumors.”
