Medical Rounds with Dr. Patricia DeFusco

As part of an alliance with the Memorial Sloan Kettering Cancer Center, the Hartford HealthCare Cancer Institute has hundreds of clinical trials now available locally, including two recently added that involve breast cancer. Dr. Patricia DeFusco, a breast surgeon at the Hartford Healthcare Cancer Institute explains.



Q. Why are clinical trials so important?
A. Clinical trials are studies that test new drugs or other improvements in caring for people with cancer. Patients in CT may benefit because they will have access to experimental treatments only at a clinical trial center such as Memorial Sloan-Kettering (MSK).

Clinical trials give patients the opportunity to potentially receive the newest, most leading-edge therapies and participate in advancing the care of future generations of cancer patients. Clinical trials are not just for patients with advanced disease.

Expanding MSK’s clinical trials also speeds up data collection so that investigational therapies can become approved faster and made available to more patients.

Q. How quickly does this research move cancer care ahead?
A. On average it would take 5-7 years for the drugs tested in clinical trials to become available to the community if the drugs are indeed found to be effective in the clinical trial. Speeding that up means better care to more people in the community.

Q. Since we are talking about clinical trials, there are two new clinical trials underway at Hartford Healthcare through MSK for breast cancer patients - tell us about those trials.
A. PALLAS is a trial in women with estrogen receptor positive (ER+) breast cancer who have completed standard therapy: surgery +/- radiation +/- chemotherapy; patients are randomly assigned to either standard endocrine therapy or standard endocrine therapy and a drug called IBRANCE or palbociclib; this drug interferes in cell division and has been found to be very effective in women with ER+ advanced breast cancer; it is hoped that its use in the postoperative will further reduce the systemic recurrence of breast cancer.

The second trial is for triple negative breast cancer (TNBC): these breast cancers lack estrogen and progesterone receptors and the HER2 protein; thus there are no specific targets on the cancer cell to direct treatment against and the only treatment option for these patients is the use of chemotherapy. Investigators at MSK and other sites have demonstrated that up to 50% of these cancers carry a protein called the androgen receptor. It may be possible to target this protein if it is present. This trial is in women with TNBC who have completed their standard therapy: surgery +/- radiation therapy and usually + chemotherapy. If their breast cancer tests + for the androgen receptor, they will receive a drug called enzalutamide. This drug blocks the androgen receptor and it is hoped that we can assess safety and tolerability in women and possibly fewer breast cancer recurrences.


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