Study: Immunotherapy may lead to long-term remission of metastatic breast cancer
Metastatic breast cancer is often difficult to treat. In a new approach, called adoptive cell therapy (ACT), a patient’s own T-cells (a type of cancer-fighting immune cells) are collected, multiplied in a lab, and then returned to the patient. The goal is to enhance the patient’s immune system with many more T-cells that recognize and attack metastasized tumor cells. This study reports on a single patient whose metastatic breast cancer is still in remission (no evidence of disease) after more than 22 months following ACT. (8/16/18)
Contents
At a glance | Media coverage |
Findings | In-depth |
Clinical trials | Limitation |
Questions for your doctor | Resources |
STUDY AT A GLANCE
This study is about:
Adoptive cell therapy (ACT), a new treatment for breast cancer that resulted in complete tumor regression in 1 patient.
Why is this study important?
Metastatic breast cancer is breast cancer that has spread beyond the breast and to other places in the body.
Metastatic breast cancer can be difficult to treat when cancer cells have spread to many parts of the body. treatment like the one in this study boost the patient’s own immune system to better fight cancer.
This study is important because it is an example of a new, personalized treatment approach that resulted in complete shrinking of one woman's metastatic breast cancer—an unusual occurrence.
Study findings:
This research is a case study of one woman with metastatic breast cancer that responsed very well to this treatment.
Before treatment, the 49-year old patient had advanced ER-positive, HER2-negatve metastatic breast cancer, with tumors in her breast, chest wall and lymph nodes. Several standard treatments, including different chemotherapies, were unsuccessful in treating her cancer.
In an ongoing clinical trial, the woman was given an experimental treatment called "adoptive cell therapy" (ACT). Researchers used the patient's own immune cells—specifically ones that could recognize and attack her tumor cells. These immune cells (called tumor-infiltrating lymphocytes, or TILs) were grown in the lab; and then injected back into the patient.
The result was surprisingly effective. At 22 months after treatment, none of the tumors that were present before treatment were detected.
Update
Read an update from the patient Judy Perkins, whose 4 cancer is still in remission as of March 2019 after treatment with T-cell therapy.
What does this mean for me?
If you have metastatic breast cancer, you will likely first receive a standard of care treatment. The study in this review is very early research. The safety and effectiveness of this treatment for a larger number of patients is not yet known. While this woman responded well and is now living with no evidence of disease (NED), researchers do not know whether her response will be typical, if it will vary between patients, if it was a fluke, or if unintended side effects might occur. It may be some time before we understand who will respond best to this treatment.
This woman was part of an ongoing clinical trial to test this treatment. This trial is enrolling participants who have metastatic breast, ovarian, endometrial or other types of cancer. Patients in this study must have a tumor that can be safely removed. Patients must have tumors that are resistant to standard treatment. If this fits your situation, you may want to consider participating in this trial or in a related study. More information on eligibility for this trial can be found here, or for other trials for metastatic breast cancer at the following link. You can search for open trials with our clinical trial research tool or through ClinicalTrials.gov.
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References
Zacharakis N, Chinnasamy H, Black M, et al. "Immune recognition of leading to complete durable regression in metastatic breast cancer." Nature Medicine. 2018;24:724-730.
Mariotto AB, Etzioni R, Hurlbert M, et al. "Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States." Cancer, Epidemiology, Biomarkers and Prevention. 2017;26(6):809-815. DOI:10.1158/1055-9965.EPI-16-0889
National Cancer Institute: "Study estimates number of U.S. women living with metastatic breast cancer." Posted May 18, 2017.
Disclosure
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
The National Comprehensive Cancer Network (NCCN) guidelines for the treatment of advanced or metastatic ER-positive breast cancer include the following:
Genetic testing
- All people diagnosed with metastatic breast cancer meet guidelines for genetic counseling and testing.
NCCN preferred treatment options
The NCCN lists the following preferred treatments for metastatic ER-positive and breast cancer:
- for people with or mutations:
- Lynparza () or () for people with an inherited BRCA1 or BRCA2 mutation.
- therapy
- A combination of hormonal therapy (aromatase inhibitor or Fulvestrant) + targeted therapy with a CDK4/6 inhibitor:
- abemaciclib (Verzenio), palbocicib (Ibrance) or ribociclib (Kisqali).
- A combination of hormonal therapy (aromatase inhibitor or Fulvestrant) + targeted therapy with a CDK4/6 inhibitor:
- For second-, third- or later lines of therapy:
- A combination of hormonal therapy (aromatase inhibitor or Fulvestrant) plus targeted therapy with a CDK4/6 inhibitor for people who have not previously received a CDK4/6 inhibitor.
- Enhertu (trastuzumab deruxtecan) for people with HER2-low ( 1+ or HER2 2+) tumors, who received chemotherapy for metastatic disease and whose cancer no longer responds to hormonal therapy.
- Piqray (apelisib) for cancers that test positive for a PIK3CA mutation.
- Oserdu (elacestrant) for , HER2-negative cancers that test positive for an ESR1 mutation.
- Lynparza (olaparib) or Talzenna (talazoparib) for BRCA1/BRCA2 for tumors with a BRCA1 or BRCA2 mutation.
- A combination of everolimus and hormonal therapy.
- Hormonal therapy alone.
- Trodelvy (sacituzumab govitecan-hziy) for HR-positive, HER2-negative after prior treatment, including hormone therapy, a CDK4/6 inhibitor and at least two lines of chemotherapy (including a taxane).
Updated: 03/21/2023
- What is the best treatment approach for my type of cancer?
- Am I eligible for the clinical trial covered in this review?
- Am I eligible for any other clinical trials?
- should I have my tumor tested for biomarkers?
- What are the risks and potential benefits of participating in a clinical trial?
The following organizations offer peer support services for people with or at high risk for breast cancer:
- FORCE peer support:
- Our Message Boards allow people to connect with others who share their situation. Once you register, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Our Peer Navigation Program will match you with a volunteer who shares your mutation and situation.
- Connect online with our Private Facebook Group.
- Join our virtual and in-person support meetings.
- Other organizations that offer breast cancer support:
Updated: 05/07/2024
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