Ed Romond: Breast cancer, we now recognize, is at least five different diseases that are
completely different than each other. And, the hardest nut to crack is this one called
triple negative breast cancer. I will give you one example. There was a woman that was
in a clinical trial, a young woman in her mid 30s, she had four kids, and she had this
aggressive kind of breast cancer. And, in the clinical trial, we first gave her a taxane,
which is one of the standard treatments, and after two treatments her cancer grew.
And it was obviously the wrong chemotherapy drug for her. So, then I switched her chemotherapy
to a different one, which was also standard, and in two weeks, her cancer was half the size.
In four weeks, it was gone. And, when she had her surgery, her cancer was completely
gone. I just saw her, five years later, and she's totally healthy, she's living her life,
and she's cured of triple negative breast cancer. And if she hadn't come here and asked
about being in a clinical trial, and been on that study, we would have never known that
about her cancer. So, that told me that she had a cancer that was very sensitive to one
chemotherapy drug and completely resistant to another chemotherapy drug. So, is there
a way that we can be smart about how we treat each patient who has triple negative breast cancer?
Aju Mathew: One of the most vexing problems that I see, especially when I see patients
with early-stage breast cancer is, what kind of treatment I should get them.
Am I over treating them? Am I under treating them?
There's unfortunately, no way I can know.
Right now, everybody gets the same concoction of medicines.
But, should I give patient A one treatment less,
or should I give patient A an extra dose of chemo? There is no way we can know
at this point in time. Now, this clinical trial is primarily intended to identify
signatures for each patient's tumor, and trying to find how that signature particularly correlates
to chemotherapy responsiveness.
Kathleen O'Connor: The concept is, is that we'll take the patient's tumor, and we'll
put it into mice, these mice become the patient's avatar. So, this now becomes her perfect replica
of how her response to these therapies will occur. And, now using these avatars, we can
actually experiment using the mice to figure out exactly which therapies will work best
for that individual patient. And, then we can come back and actually treat the patient
with those therapies. It takes probably about 3 months for us to start getting the tumors
growing up in our avatar mice. Now, then we have to transplant these tumors into new
mice in order to do the experiments, which again takes another month or so. So, our thought
was if we take biopsies, and now take the biopsy material and put it into the avatar
mice, this will give us the, about six months neoadjuvant therapy prior to surgery to actually
grow up the tumors in the mice. This gives us time to figure out whether the patient received the
right therapies to treat their tumor, or whether they might need additional therapies to actually
kill off any tumor cells that might remain, and be eventually life threatening.
The important thing is that we need to get the tissues
before they've actually been exposed to chemotherapies.
We don't have the money to really get this trial going. We have gotten a large group
of people that have freely given their time up to this point. We have oncologists,
we have multiple pathologists that are really interested in this work, we have our radiologist
who's willing to do the biopsies. We have researchers. Each of these avatar mice are
now $224 a piece. That's really what we need, is the either grant money, or philanthropic
funds, in order to move this forward. Everything else is in place.
Ed Romond: That's the goal of the cancer center; to not just do clinical trials, and not just
do laboratory research, but to figure out how you can combine them and get the insights
from the laboratory to translate into what better care for our patients.
Aju Mathew: For Markey Cancer Center, I think this is a great example of the kind
of precision medicine initiatives that we are attempting to pursue.
This is our way of disrupting the current standard of care, the current technology, the current practice
of medicine, and trying to change it, and try to change the paradigm of "one size fits
all" approach for triple negative breast cancer patients.
Ed Romond: It comes down to the patient in the end, and in the beginning,
and all the way through.