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Fifth Annual Metastatic Breast Cancer Forum

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An overview of the Fifth Annual Metastatic Breast Cancer Forum, held annually at Dana-Farber Cancer Institute.

Veröffentlicht in: Gesundheitswesen
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Fifth Annual Metastatic Breast Cancer Forum

  1. 1. Fifth Annual Metastatic Breast Cancer Forum Saturday, September 24, 2016
  2. 2. Forum Chair Nancy Lin, MD Forum Co-Chairs Liz Frank Lauren Knelson
  3. 3. Overview • What is metastatic breast cancer? • What is EMBRACE? – Clinical program – Research study • How else are we learning about metastatic breast cancer?
  4. 4. What is Metastatic Breast Cancer? • Cancer that has spread outside of the breast and local lymph nodes • Frequently can be controlled with current treatments, but length of disease control can be quite different between patients and from one treatment to the next – One size does not ‘fit all’ – Not a set treatment course; unpredictability, ups and downs • Usually not ‘curable’, but some patients can live for many years with good quality of life • An area of very active research – we are making progress!
  5. 5. • There are three main subtypes of breast cancer • Within these, there are other ways to further sub-divide breast cancers • Oncologists use the breast cancer subtype to guide the kinds of treatments to recommend • Clinical trials often will focus on specific subtypes Breast Cancer Subtypes
  6. 6. Breast Cancer Subtypes Breast Cancer Subtypes ER-positive HER2-positive Triple-negative TALK to your doctor if you are not sure what type of breast cancer you have
  7. 7. Hormonal therapy Hormonal therapy Chemotherapy Chemotherapy Chemotherapy Chemotherapy Chemotherapy Herceptin + perjeta + chemotherapy TDM1 Lapatinib + Capecitabine Herceptin + chemotherapy Herceptin + chemotherapy Hormone receptor (ER) positive Triple-negative HER2-Positive *Note, these are just examples. Each patient is different and treatment is tailored accordingly. How Do We Treat Patients with Metastatic Breast Cancer?
  8. 8. Social Emotional SpiritualIntellectual Physical
  9. 9. Why EMBRACE? •Support your doctor at DFCI to be aware of trial options, research testing results, and facilitate care •Interface with referring/local oncologist to improve ease of communication and enhance collaborative care •Support patients by facilitating access to supportive care services, providing educational forums and materials •Support research efforts, including the EMBRACE research study PILOT begun summer 2015, full roll-out August 2016
  10. 10. Clinical Trial “Prescreening” • Some trials only enroll patients whose tumor tests positive for a specific marker • EMBRACE program facilitates testing, think ahead – Oncopanel – Trial specific testing – Coordination with biopsy study
  11. 11. EMBRACE Clinical Program: Coordinators Maggie Merrill Rebecca Santiago Nicole Kuhnly Lindsey Crowley Gunjan Gupta Kathryn Silva
  12. 12. What is the EMBRACE research study? Patient consent* Blood samples for research Records review into database *also includes permission for research on existing tissue samples
  13. 13. −1.0 −0.5 0.0 0.5 1.0 Frequency 1 2 3 4 5 6 7 8 9 10 11 12 13 15 17 19 22 n=19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 X FrequencyAltered 1.0 0.5 0 0.5 1.0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 X FrequencyAltered 1.0 0.5 0 0.5 1.0−1.0 −0.5 0.0 0.5 1.0 Frequency 1 2 3 4 5 6 7 8 9 10 11 12 13 15 17 19 22 n=19 Primary TNBC Tumor tissue Metastatic TNBC (EMBRACE study, 87 patients) Cell-free DNA Example: Triple Negative Breast Cancer Slide courtesy of Dan Stover, MD
  14. 14. Example: ER+ Breast Cancer Blood Blood Matched tumor Heather Parsons, Viktor Adalsteinsson, Gavin Ha, Sam Freeman, Nick Wagle, Dan Stover
  15. 15. Metastatic tumor biopsy (3-8 cores) & blood samples Patients with ER+ MBC Core 2 Core 4 - 5 Core 6++ WES + RNASeq Cell Lines / Mouse Models CLIA Tumor Bank Single Cell RNA-seq Studies of Resistance and Heterogeneity Functional Studies / Co- Clinical Trials Future Studies cell free DNA (cfDNA) for WES and hotspot profiling Serial Blood Samples Core 1 Pathology ER, PR, HER2 Returned to Physician 94 biopsies from 88 patients July 2015 – May 2016 CLIA Targeted Seq Panel Core 3 Biopsy Study Wagle et al, ASCO 2016
  16. 16. What Type of Breast Cancer? Have you received: Trastuzumab (Herceptin), pertuzumab (Perjeta), Kadcyla (TDM1), or Lapatinib (Tykerb) YES HER2-Positive Yawkey 306/307 NO Have you received: Tamoxifen, letrozole (Femara), anastrazole (Arimidex),Exemestane (Aromasin) YES ER-Positive In this room NO Triple-negative Smith 308/309
  17. 17. Funding Sources • Grant from the National Comprehensive Cancer Network-Pfizer • Fashion Footwear Association of New York • Pan-Mass Challenge • Breast Cancer Research Foundation

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