Breast cancer trials making an IMPACT at LVHN
Memorial Sloan Kettering Cancer Alliance offering effective treatments for area patients
For the past three years – thanks to their alliance with world renowned cancer center, Memorial Sloan Kettering (MSK) – Lehigh Valley Health Network has been one of only three health care networks in the country that has been able to offer local breast cancer patients access to groundbreaking Sloan Kettering clinical trials with new medications that are earlier in development. MSK-IMPACT™ stands for “integrated mutation profiling of actionable cancer targets.” Simply put, the testing can detect mutations and other critical changes in the genes of both rare and common cancers. “We’re trying to find out what mutations are making the cancer tick, so we can try to treat the mutation. There are roughly 20,000 genes in every cell in our body, and cancer usually happens because of mutations in about 450 or so of these genes,” explains Suresh Nair, MD, Physician-in-Chief at LVHN’s Lehigh Valley Cancer Institute. “With MSK IMPACT, doctors can quickly find out whether a tumor has changes that make the cancer vulnerable.” According to MSK, a notable feature of IMPACT is that two DNA samples from each patient are sequenced and compared: DNA from tumor tissue and DNA from normal tissue, which is usually a blood sample. Directly comparing the tumor’s genome to the genome in normal blood ensures that the mutations detected by MSKIMPACT are specific to the cancer cells. When the trial first opened up locally, the cost of testing was several thousand dollars per patient. Though it has dropped significantly, the cost of treatment is still a burden on top of the stresses that cancer patients are already dealing with. LVHN trial participants have been able to have their testing covered by funds raised through the Women’s 5K Classic, a local run/walk that is in its 27th year of securing donations for and providing education about breast and other female cancers. “When the MSK study launched, I kept thinking, ‘We have to get some grants.’ I didn’t want to charge patients for the test, because it was research. I wanted everyone to have equal access,” Dr. Nair explains. “I talked to Wendy Body and some of the other committee members for the Women’s 5K Classic, about the path to starting this research. They really supported this. Soon, we got to the point where everybody who came into the Cancer Institute with breast, ovarian, cervical or uterine cancer and needed testing, the Women’s 5K had their back.” About 65 local women have undergone testing through the IMPACT trial. One who was able to benefit very early on is Bloomsburg resident Kathy Lowe, a cancer survivor of 21 years who was initially diagnosed with breast cancer in 1998 and had a recurrence (now metastatic cancer) 17 years later. “What the test does is identify something going on in the body that’s driving the cancer. Mine was AKT (AKT1 E17K), and they were trying to figure out how to block that mutation from driving my tumor,” explains Lowe. “I’ve been able to go to Allentown to get access to the same treatment I would get if I had gone to Manhattan, and we are so lucky to have Dr. Nair here in the Lehigh Valley.” What made Lowe’s treatment unique is that she was part of what is known in medical circles as a “basket trial” – which means that regardless of where someone’s cancer is in the body (the physical location of the tumor), researchers use the same type of targeted therapy treatments from patient to patient (for example, the same therapy could be tested on a breast cancer patient that was being tested on a lung cancer or testicular cancer patient). “It allowed me to have a drug that has been used on some of the other cancers but had never been used for breast cancer. It was a trial of one – it was the Kathy Lowe trial,” Lowe laughs. “Dr. Nair worked for six months writing it, getting it FDA approved, and then finding a drug company that would take the risk of taking it on.” Lowe says that a journey with a metastasis is like riding a train, and that particular train is the treatment you’re undergoing at the time. Then, she says, you get off on the platform and wait for the next train – one that will hopefully buy you more time. “That’s why research money is so important. That’s why the trials are so important,” she stresses. “And to have access to that right here in Allentown… it’s a clinical team of fantastic doctors and nurses who are keeping it all together.”