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Originally published December 4, 2024
Last updated December 4, 2024
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As a pioneer in breast cancer treatment, Keck Medicine of USC currently offers more than 25 clinical trials for breast cancer patients. It’s only the beginning.
Daphne Stewart, MD, a breast cancer oncologist with the USC Breast Center and the USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC, explains why researchers at USC Norris are working to scale up the health system’s clinical trial program for breast cancer.
One reason is that the COVID-19 pandemic slowed down not only the number of clinical trials in progress but also the number of clinical trial participants. “The pandemic really shut down a lot of patients’ interest in and access to clinical trials,” Stewart says. “There were a lot of limitations in being able to get people into clinical trials.”
“Now,” she says, “we’re focused on increasing participation again.”
Keck Medicine clinicians and researchers are actively investigating future therapies for breast cancer. These include vaccines to help fight metastatic breast cancer, evolving treatments for triple-negative breast cancer and novel medications for patients diagnosed with early-stage breast cancer. Stewart describes some of the clinical trials in progress.
One clinical trial is examining curative therapy prior to surgery based on cancer gene profiling. This trial, known as the ISPY neoadjuvant trial, is for patients with early breast cancer who may benefit from systemic (whole body) therapy before surgery to improve their surgical and survival outcomes. They are treated with personalized novel medications based on their unique cancer gene profile, targeting the drivers of cancer growth.
Keck Medicine researchers are also investigating several novel therapies for advanced breast cancer such as vaccines to stimulate immune cells to fight the cancer and T cell therapy. T cell therapy has already shown to be a successful treatment for blood cancers such as multiple myeloma and leukemia.
Other clinical trials may benefit patients by offering treatment plans that might prove less invasive or have fewer side effects. At Keck Medicine, researchers are offering a post-treatment study for premenopausal women to de-escalate chemotherapy, which causes a range of side effects, by using less toxic and possibly more effective endocrine therapy instead. They are also examining if radiation, another staple for destroying cancer cells, can safely be skipped for some patients, potentially avoiding the side effects like fatigue and skin irritation.
Stewart estimates that half of breast cancer patients currently being treated at Keck Medicine will consider participating in a clinical trial. “The most motivated patients are those who have exhausted standard-of-care opportunities,” she adds.
Stewart and her colleagues at Keck Medicine are committed to increasing the slate of active clinical trials so that as many patients as possible can be matched with an appropriate trial. “Our goal is to make sure that we maintain a large trial portfolio here on site for our patient population,” she says.
A patient’s cancer type, stage, and family and personal history all factor into their potential for enrollment. At Keck Medicine, multidisciplinary teams comprising surgeons, radiation oncologists and medical oncologists convene every week to review patient cases — and to determine if a patient might be suited for a clinical trial.
There is still much to learn about the diagnosis and treatment of breast cancer. “We’ve made a lot of progress, but there is still a lot more progress to be made in the future in terms of how to optimize treatment by offering more effective therapies or potentially offering less-toxic therapies” Stewart says. Clinical trials are a powerful tool for advancing the state of care, and there is much more to come from USC Norris, she concludes.
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