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Researchers in South Florida are testing several vaccine strategies to prevent or treat breast cancer.
So far, early trials show some promise for a breast cancer preventive vaccine, a curative vaccine for aggressive late-stage breast cancer, or even a survivor-targeted vaccine to prevent breast cancer from recurring.
Most of the trials focus on training cells to recognize tumors as foreign. Until now, researchers have found it difficult to identify the abnormalities picked up by breast cancer cells. This is because breast cancer cells often have mixed characteristics with normal cells. But through trials, researchers are learning how to perform a more sophisticated analysis of the genetic make-up of tumor cells to target foreign cancer markers.
At the University of Miami’s Sylvester Comprehensive Cancer Center in Plantation, where Jill Biden recently visited to spread breast cancer awareness, a trial for a breast cancer vaccine was underway, and another trial had just finished, with the results Pending.
“Vaccines are interesting because they are a form of immunotherapy that will change the way cancer is treated,” said Dr. Alejandra T. Perez., Medical Director of the Brahman Family Breast Cancer Institute in Sylvester, Plantation.
[ RELATED: First lady Jill Biden hopes to draw attention to breast cancer during Broward visit ]
Researchers say a vaccine could be a better way to treat advanced breast cancer than radiation or chemotherapy by killing cancer cells without harming healthy cells and without side effects. says.
A year-long vaccine trial in which Sylvester of UM participated with the Mayo Clinic focused on preventing the recurrence of triple-negative breast cancer, the most aggressive and deadly form of breast cancer, after women complete chemotherapy and other treatments. was The trial has just concluded, and Perez said early results are encouraging. “It’s hard to know that in a clinical trial, but our patients did well.”
Fort Lauderdale attorney Karen Amlong joins the trial and has hope. Amlong, 75, learned in August 2021 that she has stage 4 breast cancer.
“It was a small lump, and I found it early, but it was an aggressive triple negative,” she said. This could be a placebo or a breast cancer vaccine.
“So far, I’m clean, and that’s good news,” she said. It’s also an opportunity to do something to help others in the same situation.”
Dr. Carmen Calfa, a breast medical oncologist and co-director of the cancer survivorship program at Sylvester Comprehensive Cancer, said the patient is now enrolled in another vaccine trial. This is known as the BriaCell vaccine trial for advanced breast cancer that has spread.
“We’re using the vaccine in combination with immunotherapy to treat stage 4 cancer and prevent it from spreading further,” Calfa explained. We’re trying to find new therapies that focus on giving.”
Perez said Sylvester also hopes to participate in preventive vaccine trials in the near future.
Meanwhile, a preventive vaccine trial is underway at the Cleveland Clinic. A health system researcher is hosting a small, early-stage trial of a vaccine aimed at preventing triple-negative breast cancer, which he expects to finish in the spring of 2023. If proven effective, the vaccine could potentially be used in at-risk women.
“In the long term, we hope that this will be a true preventative vaccine administered to healthy women to prevent the development of triple-negative breast cancer.” G. Thomas Budd, M.D., Ph.D. The study’s principal investigator said when the trial was announced.
A future large-scale trial at the Cleveland Clinic in women with the BRCA1 or BRCA2 genes who are at risk of developing triple-negative breast cancer could begin in the second half of 2023, but the multi-stage trial and the FDA review may take several years.
While much depends on the outcome of vaccine clinical trials, Perez and Calfa of UM are cautiously optimistic that in the near future, treating breast cancer will be different and vaccines will play a role.
Progress is not fast enough for millions of women. According to the American Cancer Society, breast cancer accounts for one-third of the new cancers diagnosed in a woman in the United States each year. It is estimated that more than 43,000 women in the United States will die from breast cancer this year. While treatment has improved and mortality rates have fallen, the number of women diagnosed with the disease is increasing each year.
In addition to clinical trials of vaccines, breast cancer doctors in South Florida are using innovative screening tools, medications and radiation options to improve how the disease is detected and treated.
A major innovation in breast cancer detection is when and how women are screened in South Florida. The focus has shifted from mammograms starting at a specific age to more diverse screening recommendations based on breast cancer risk.
At the Baptist Health Lynn Cancer Institute in Boca Raton, Dr. Kathy Schilling Risk factors she uses include breast density, age, family history, and hormone exposure.
“We recommend that all women undergo a formal risk assessment to determine their level of risk,” Schilling said. “People who may have a genetic susceptibility who are at higher risk should start screening earlier and more intensively.”
[ RELATED: Breast Cancer Awareness month events around South Florida in October. ]
Screening tools currently include 3D mammography, ultrasound, and MRI. Lynn also offers contrast-enhanced mammography, Schilling said.
As Lynn transitions to digital 3D mammography, artificial intelligence scans every image at no additional cost to patients, Schilling said. This advance will save lives, she said.
“Computers don’t get tired and they can see things that the human brain and eyes can’t perceive. We’ve noticed better cancer detection rates using this tool. We are finding very small cancers, 3, 4, 5 milliliters, that would have been found years ago if we hadn’t used this technology,” said Schilling.
As a bonus, she said the technology also detects potential heart disease.
Many women have breast cancer surgery and may also receive additional treatments such as chemotherapy, hormone therapy, and radiation after surgery.
A Florida oncologist says treatment is becoming more individualized as medical knowledge advances.
Sylvester’s Calfa said:
At the Cleveland Clinic in Weston, Dr. Cassann Blake, a surgical oncologist, says women with tumors now have more options and the surgery is less invasive.
“More and more patients are getting chemotherapy before surgery,” she said. “Doing it first in women with lymph node metastases can reduce aggressive lymph node surgery. You don’t have to be so aggressive for that.”
Some women have the option of removing the tumor at the same time as plastic surgery to shrink and lift both breasts, Blake said, because screening has found the mass earlier and making it smaller. It is now
At Lynn, Shilling said trials have begun to offer a full surgical option. “There is a lot of innovation going on, a lot of progress.”
Radiation is another area where changes are improving breast cancer treatment.
Dr. Marcio Fagundes, a radiation oncologist at Baptist Health South Florida’s Miami Cancer Institute, says pencil beam proton therapy, which is used for other types of cancer, is now being applied to breast cancer. This treatment can precisely target tumors and deliver high doses of radiation.
“The advantage is that you don’t hit the radiation where you don’t want it,” Fagundes said. “The heart, lungs, and certain lymph node areas can be spared from exposure without sacrificing tumor-targeting radiation. to minimize damage to
“We are all moving towards making radiation more selective and safer where possible,” he said.
In the fight against breast cancer, South Florida oncologists are trying at least a dozen experimental drug treatments to slow or cure the disease.
In some cases, these drugs have already been successfully used against other types of cancer.
Calfa at Sylvester is the principal investigator for the TAPUR trial. The TAPUR trial is a national, end-stage cancer trial that uses FDA-approved drugs off-label for other types of cancer to combat breast cancer based on the patient’s tumor characteristics. research. .
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“We’ve seen some surprising responses in patients who were otherwise hopeless and had no other appropriate interventions,” said Calfa.
In another trial, Calfa used taxol, already used for breast cancer, in combination with radium, which is used for prostate cancer. “We are investigating whether the combination of taxol improves patient outcomes.”
Sylvester cancer patient Trish Gainer Gaddis is a study participant.
Gaddis was diagnosed with breast cancer in 2011 when she was just 51 years old. She is currently 62 years old and battling stage 4 breast cancer. Gaynor says he’s in clinical trials for two reasons. “I hope this drug will extend my life,” she said. “And I want to help people like me.”
Most people don’t realize that breast cancer comes in multiple types and subtypes under its umbrella, Calfa said.
“Finding one treatment is not a home run,” she said. “
Sun Sentinel Health Reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
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