Immunotherapy: The Ultimate In Personalised Medicine
Immunotherapy has become a buzzword in oncology in recent years, thanks to its success in treating certain cancer types. It is not yet in routine use in the clinic as a treatment option for breast cancer in Australia, but breast cancer researchers are learning from the experiences of researchers in other cancer types such as melanoma, lung cancer and bladder cancer, that previously had limited treatment options.
Breast Cancer Trials has opened two new trials, DIAmOND and CHARIOT, which uses different combinations of immunotherapy in patients with breast cancer subtypes that are more likely to respond to immune manipulation. The study chair for these two clinical trials is Professor Sherene Loi.
But what is all the hype around Immunotherapy?
Dr Nick Zdenkowski is the Medical Advisor at Breast Cancer Trials and a practicing oncologist in Newcastle, NSW. He said he has noticed an increase in patients asking about the treatment.
“I see a lot of patients who are asking about these drugs and it’s difficult to respond at present because it’s not available in Australia for the treatment of breast cancer in routine practice.”
“I think a lot of the time they don’t appreciate how different the different cancer types are, and even within breast cancer they don’t appreciate how different, the different breast cancer types are.”
But for those who are eligible, immunotherapy could provide a new treatment option.
“Cancer is really good at avoiding control by the immune system. It essentially hides, and that means we need to use other things to try and attack that cancer” said Dr Zdenkowski.
“With the invention to immunotherapy, it is taking the breaks off the immune system. It’s getting cancer to become visible to the immune system, so the immune system can then attack it.”
“The immune system’s really good at working out what’s foreign and if you take an immune cell and present something to it, it can work out a way of attacking that foreign protein and thereby killing off the cell that is expressing it.”
The CHARIOT Clinical Trial
The CHARIOT trial is looking at the neoadjuvant setting for patients who have breast cancer that could be removed by surgery but are having chemotherapy before that surgery to try and reduce the size of the cancer. It will be open to patients with triple negative breast cancer who have had an incomplete response halfway through their chemotherapy.
“They’re put onto the trial and are given a dual immunotherapy plus chemotherapy agents” said Dr Zdenkowski. “This is in the hope of stimulating a response in cancer that is resistant to traditional chemotherapy agents.”
“We see that breast cancer sometimes responds really well to chemotherapy, and that’s great. But the patients who don’t respond have a poor prognosis and we want to turn that around. We want to improve those patients prognosis.”
Listen to the podcast
Dr Nick Zdenkowski discusses the relevance of immunotherapy in breast cancer and the Breast Cancer Trials CHARIOT and DIAmOND clinical trials.
The DIAmOND Clinical Trial
The DIAmOND study is for patients with metastatic HER-2 positive breast cancer, which is a tumour type that tends to respond better to immunotherapy. The DIAmOND trial comes off the back of the PANACEA trial. It will use dual immunotherapy with the HER-2 directed treatment.
“This DIAmOND study is looking at taking patients with metastatic HER-2 positive breast cancer to induce a response and disease control for as long as possible, with the hope that some of those patients will achieve a very durable response, similar to that seen in patients with melanoma and lung cancer.”
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