Joining FORCES is the FORCE newsletter with news, views and supportive information for individuals concerned about hereditary breast and ovarian cancer.
by Susan Lilly
Dr. Melinda Telli (Stanford University Medical School) presented on the latest clinical research for hereditary metastatic breast cancer (MBC). Treatment options are available, with the goal of improving survival, alleviating symptoms, preventing complications, and limiting toxicity while optimizing quality of life. Many women are long-term survivors of metastatic breast cancer.
Dr. Telli presented promising treatments that are currently being investigated in clinical trials. Cancer research is moving towards more individualized therapies, targeting tumor proteins and molecules called “biomarkers” to develop treatments that block cancer growth. BRCA mutations may become an important biomarker for treatment, but at present, outside of surgical decisions such as lumpectomy or mastectomy, mutation status is not used to guide breast cancer treatment.
Prior research suggests that BRCA-related cancers respond well to chemotherapy in generally, however, little is known about which chemotherapy regimens offer the best outcomes for mutation carriers. We do know from small studies that PARP inhibitors, which block DNA repair in cancer cells, show promise for BRCA1 and BRCA2 mutation carriers with advanced breast cancer, but they have not yet been approved by the FDA. In addition, small studies show that platinum chemotherapy (e.g., cisplatin) is very active in BRCA-related breast cancers. Based on these findings, the question of whether BRCA status should be used as a biomarker for treatment selection is being studied by oncologists.
PARP inhibitor clinical trials for patients with advanced breast cancer are ongoing. Many large studies that are underway could lead to FDA approval if they show that PARP inhibitors are more effective than standard therapies. Open studies include BROCADE (veliparib), EMBRACA (BMN 673), BRAVO (neraparib) and OLYMPIAD (olaparib), which are currently recruiting patients to evaluate the effectiveness of PARP inhibitors with or without chemotherapy, and the ABRAZO study (BMN 673) that is open to those who have undergone many prior therapies for metastatic disease or who have previously received platinum. A trial of BMN 673 will also be launched in patients who do not have BRCA1 or BRCA2 mutations, but who do have other less common mutations associated with hereditary breast cancer, including PALB2, ATM, BARD1, BRIP1, and RAD51, among others.
A Spanish company, PharmaMar, is recruiting patients for trials of its new drug PMO1183 to treat BRCA1 and BRCA2 mutation carriers with MBC. PMO1183 is a DNA-damaging chemotherapy agent that attacks the cancer differently than platinum. It looks promising for BRCA-related cancers, and it does not cause hair loss.
Dr. Telli concluded by introducing immunotherapy, an area of research that she considers promising. It stimulates a person’s own immune system to help fight and kill cancer cells. In the future, immunotherapeutic approaches might be particularly relevant in mutation carriers, but right now the research is ongoing.
FORCE has built a clinical trial search tool that is enriched with prevention, detection, treatment, and quality-of-life studies recruiting people with HBOC. The tool allows you to search by type of study, city or region, type and stage of cancer, and type of research.
You can find a list of studies open to people with metastatic hereditary breast cancer on the FORCE Featured Research page.