Keeping Abreast of Immunotherapy in Breast Cancer
Once considered “immunologically silent,” breast cancer may actually respond to immunotherapy.
PUBLISHED: OCTOBER 20, 2016
PATTY SPEARS was not eligible to take Herceptin when she was diagnosed with HER2-positive breast cancer in 2000, so she tried an experimental vaccine. - PHOTO BY ROBIN LIN
In the summer of 1999, when she was just 40 years old, Spears was diagnosed with an aggressive form of breast cancer. A little over a year after a baseline mammogram that had revealed no signs of cancer, Spears had lumps that she could feel in her breast and under her arm. Within a week of reporting the lumps to her doctor, Spears had a mammogram, a biopsy, an appointment for her first round of chemotherapy and a consultation with a surgical oncologist.
“The tumor was as aggressive as it could be,” Spears recalls. “I had every negative prognostic marker. I was premenopausal. It was HER2-positive, highly HER2 expressing, and it was estrogen receptor-negative.
Today, Spears would have been a candidate for the game-changing medication Herceptin (trastuzumab), which treats breast cancers that overexpress the protein HER2, since her cancer was diagnosed at stage 2b. But at the time, only people with metastatic breast cancer received the drug. So, instead, Spears received eight rounds of chemotherapy, which included Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) and Taxotere (docetaxel), followed by a bilateral mastectomy and then radiation.
While bilateral mastectomy significantly reduces risk of recurrence, Spears felt her risk was especially high and wanted to do more. A research specialist in microbiology at North Carolina State University College of Veterinary Medicine, Spears had her finger on the pulse of emerging science. A colleague in immunology told her about a family member who had avoided melanoma recurrence after receiving an experimental vaccine. Spears set to work to find a clinical trial for a breast cancer vaccine. She found one at the University of Washington in Seattle.
Spears flew to Seattle once a month for six months to receive an injection in her arm of a vaccine designed to prevent recurrence of breast cancers that overexpress the HER2 protein. This protein can cause breast cancer to grow faster, spread faster and come back. The early-phase trial evaluated the safety of the vaccine and whether dose impacted the immune system’s response.
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