10/6/2015

Physicians at Magee-Womens Hospital of UPMC and the University of Pittsburgh Cancer Institute (UPCI) have opened a clinical trial to learn more about how three commonly prescribed anti-estrogen therapies affect the tumor tissue of patients diagnosed with invasive lobular breast cancer (ILC), a less common and understudied type of breast cancer. This is the first study of its kind to employ a prospective clinical trial approach to understanding ILC, doctors said.

Patients with ILC represent 5 to 15 percent of breast cancer patients, and it is unclear how their cancers differ from those with invasive ductal carcinoma (IDC), which is much more common. Previous laboratory models studied by researchers at the Womens Cancer Research Center (WCRC) at UPCI and Magee-Womens Research Institute and Foundation (MWRIF) suggest that patients with ILC may respond differently to anti-estrogen therapies commonly given to those with either cancer type.

“Currently, there is a one-size-fits-all approach in how we treat patients with invasive lobular breast cancer and invasive ductal carcinoma,” said Rachel Jankowitz, M.D., assistant professor of medicine in the University of Pittsburgh Division of Hematology/Oncology, medical director of the Magee-Womens Hospital Breast and Ovarian Cancer Risk Assessment and Prevention Program, and the trial’s principal investigator. “Our goal is to increase understanding of how to tailor treatment for women with ILC in order to ultimately improve their long-term outcomes.”

Study participants will be randomized into three groups that will receive one of three different drugs that are commonly used in breast cancer treatment during the 21-day period before surgery is performed.

“Our trial will examine how ILC tumor tissue responds to the current standards of care – treatment with either Tamoxifen or Anastrazole, as compared to Fulvestrant, a drug currently approved only to treat advanced breast cancer,” said Steffi Oesterreich, Ph.D., professor in the Pitt Department of Pharmacology and Chemical Biology, and the WCRC’s director of education, who will direct the analyses of the breast tumor tissues to identify molecular markers of response or resistance to therapies.

Dr. Jankowitz’s team plans to open the study at several other large cancer centers that have expressed interest in enrolling their patients through the Translational Breast Cancer Research Consortium (TBCRC), a collaborative group of 17 clinical sites that aims to conduct innovative and high-impact clinical trials for breast cancer.

The trial is supported by the Susan G. Komen Foundation and by AstraZeneca.