iNto toMorroW’s treatMeNts collaborating on an innovative approach to chemo-resistant breast cancer
“Mifepristone is an Fda-approved medication used for emergency contraception. Mifepristone, however, is also a powerful blocker of gr activity,” Nanda explained. “the goal of our study is to see if combining mifepristone with standard chemotherapy can improve outcomes for patients with advanced breast cancer.”
resistance to conventional treatment is a roadblock that most patients with metastatic breast cancer face. the situation leaves few alternatives for treatment, but a novel approach now is in clinical trials at the University of chicago Medicine.
to support this work, Nanda and conzen applied for funding from the University of chicago’s institute for translational Medicine (itM). in November 2011, Nanda’s project was awarded funding to begin a phase 1 clinical trial to determine the appropriate dose of mifepristone to combine with the standard chemotherapy drug nab-paclitaxel (abraxane).
the collaboration between physicianscientist suzanne d. conzen, Md, and clinical researcher rita Nanda, Md — both experts in the diagnosis and treatment of breast cancer — stems from conzen’s groundbreaking research on signaling pathways and their role in cancer.
Nanda enrolled the first patient in the study in January 2012, and to date a total of eight patients have joined the study. conzen and Nanda were recently awarded a $675,000 grant from the susan g. komen Foundation to further this research. this grant will allow the investigators to study the effects of gr on chemotherapy effectiveness, namely in patients with triple-negative breast cancer.
conzen, who has been studying chemotherapy resistance since opening her lab in 1998, observed that the stress hormone cortisol activates the glucocorticoid receptor (gr) pathway and contributes to chemotherapy resistance in a subset of breast cancers. a meta-analysis of published studies revealed that the gr is overexpressed in 40 percent of advanced breast cancer cases. this led conzen to theorize that tumor activation of the gr protected some cancer cells from cell death and ultimately made them resistant to chemotherapy. conzen and Nanda designed a trial to test this hypothesis in patients with advanced breast cancer.
“the ultimate goal of our study is to improve outcomes for patients with advanced breast cancer,” Nanda said. “if we can do that while maintaining quality of life, then we will have accomplished something incredibly significant.”
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CLInICAL TRIAL ELIGIBILITy
This trial is one link in a long-standing research effort examining connections between stress and cancer. Referral of any qualified patients who may be interested in participating is appreciated, and progress will be reported. KEy ELIGIBILITy REqUIREmEnTS InCLUDE:
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Metastatic or locally advanced unresectable breast cancer
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evaluable disease
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Up to four prior cytotoxic regimens for advanced breast cancer
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No prior nab-paclitaxel for metastatic disease
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Peripheral neuropathy ≤ grade 1
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No need for corticosteroid therapy
Questions about the protocol may be directed to Jean gibson, rN, at 1-773-834-2167.
Physician RefeRRal line 1-800-824-2282 | UCHICAGOKIDSHOSPITAL.ORG | UCHOSPITALS.EDU » 5