Tag Archive for: precision oncology

A Breast Cancer Expert’s Hope for the Future of Care

A Breast Cancer Expert’s Hope for the Future of Care/a> from Patient Empowerment Network on Vimeo.

Is the future of breast cancer care hopeful? Expert Dr. Bhuvaneswari Ramaswamy shares encouraging research advances and discusses specific areas in need of improvement for all breast cancer patients.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

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Transcript:

Katherine:

Well, to close out our conversation, Dr. Ramaswamy, I’d like to get your thoughts on where we stand with research progress. Are you hopeful?

Dr. Ramaswamy:   

Extraordinarily hopeful. I mean, and I say this like I even said before, some of the things I was skeptical about. I have to pull back my skepticism, which I’m very, very happy about. The role of immunotherapy starting to come into breast cancer, newer drugs, oh my God, therapeutics has improved our understanding of how to prevent these cancers. Picking up those high-risk patients, looking at these liquid biopsies, our understanding of genomics and precision oncology, I just have so much hopes. Management of brain mats with radiation treatments that are so targeted, improving, reducing, or mitigating the side effects with the treat – with the less treatments for those patients who have less risk. I mean, in every possible way, we are improving the way – what we are doing. Can we do better? Particularly in some areas I do want to bring it out. I think we still lag behind in health equity.

I think still a in African American patients with the breast cancer has a higher risk of dying from breast cancer. We haven’t really impacted it as well as we can do. I think understanding the ancestry, understanding the risk, understanding the lifestyle behaviors that increases the risk of these aggressive  cancers, say in African American women and in and those are very, very important. Prevention is so much better than cure, right? So, I think a little bit better of our understanding on prevention and the liquidity. Both access and understanding the biology and treatment. Improving our clinical trial approvals. We still only even in the best cancer centers, we only approve 25 percent of our patients, 15 to 25 percent of our patients into cancer clinical trials. And look at the changes we’ve had.

But imagine if we can put 50 percent of our patients on clinical trials, we’ll double the progress because without those clinical trials, none of these drugs can be approved.

Katherine:                     

Yeah.

Dr. Ramaswamy:          

So, what is today in a clinical trial is what is a tomorrow-approved drug. So, our understanding and talking about that becomes very very important for us. And then I think lastly, there are some breast cancers like invasive lobular cancers that are only 15 percent that we still don’t understand as well. And so there are some more little pockets that   I think we still need to understand. Male breast cancers are slightly starting to increase. We need to improve. So, there are areas we can do better, but overall, it’s absolute promising and very, very happy today. Our research is going really well, so, and it’s impacting patients’ outcomes.

Are We Getting Closer to Precision Oncology for Prostate Cancer?

Are We Getting Closer to Precision Oncology for Prostate Cancer? from Patient Empowerment Network on Vimeo.

Is there progress in precision oncology for prostate cancer? Dr. David Wise shares his perspective about precision oncology and an update about ongoing research. 

Dr. David Wise is Director of Genitourinary Medical Oncology at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health. Learn more about Dr. Wise.

See More From INSIST! Prostate Cancer

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How Can You Access Personalized Prostate Cancer Treatment?

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How Do Biomarker Test Results Impact Prostate Cancer Treatment Options?

Prostate Cancer Treatment_ What Is Precision Oncology

Prostate Cancer Treatment: What Is Precision Oncology?


Transcript:

Dr. David Wise:

Sure. So, yes. One of the key steps going forward for our research is to look for more of these precision targets that we can take advantage of. We certainly think that there are more genetic features out there that have yet to be treated effectively. And so, those are the kinds of treatments that we’re really excited about.  

And so, along those lines, we have clinical trials here that are looking at specific mutations in the androgen receptor gene, for example, which is a clear gene that promotes the development of prostate cancer and its resistance to established treatments. So, we have clinical trials here targeting the androgen receptor, particularly when it’s mutated, okay? So, that’s one example. We have immunotherapy trials here that are really looking to target PSMA, so with the same sort of precision target.  

But instead of looking for a different target, we’re trying to treat the same target but with a different treatment modality. So, instead of using radiation targeted towards that PSMA, we’re trying to use antibodies that bring the immune system towards that target in order to provide a potentially better tolerated and longer-lasting treatment to patients with PSMA on their cancer.  

And even taking it to the next step, what we’ve found is that…how do we help boost the long-term durability of our treatments? A lot of these precision treatments give us an initial excellent result only to eventually stop working. And so, how do we extend durability? That’s a very important area of research. And we think part of that is boosting the immune system’s response to the treatment. And so, we’re actually also going to begin a trial in the next few months, which we think is really exciting, where we’re combining lutetium PSMA to target those PSMA-expressing prostate cancers.  

But then we’re combining that with a type of immunotherapy that we think will more fully expose the cancer to the treatment effect and remove some of the barriers in the body towards fully killing those remaining cancer cells. 

Prostate Cancer Treatment: What Is Precision Oncology?

Prostate Cancer Treatment: What Is Precision Oncology? from Patient Empowerment Network on Vimeo.

How is precision oncology used in prostate cancer? Dr. David Wise defines precision oncology and explains how it is used in conjunction with prostate cancer testing for patient care.

Dr. David Wise is Director of Genitourinary Medical Oncology at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health. Learn more about Dr. Wise.

See More From INSIST! Prostate Cancer

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How Can You Access Personalized Prostate Cancer Treatment?

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Are We Getting Closer to Precision Oncology for Prostate Cancer

Are We Getting Closer to Precision Oncology for Prostate Cancer


Transcript:

Dr. David Wise:

Absolutely. So, precision oncology is really a term that describes being able to tailor treatment to a patient’s cancer to the information that we have from that specific individual. So, it’s really tailored medicine. And it’s precise because, typically, that treatment is leveraging or exploiting a specific vulnerability or feature that we’re able to discern by a specialized testing of that patient’s cancer, okay?  

And so, everything that I’ve been discussing, biomarker testing that lends itself directly to treatment is largely overlapping and very much an example of precision oncology. So, using genetic test results to guide treatment from that patient, that’s tailored to that patient. So, that is precision oncology.  

Using that patient’s PSMA profile to determine the benefit of lutetium, that is, in my view, precision oncology. There are other examples of this in multiple different spheres and using multiple different treatment types, but that’s the general concept. I think the other example of precision oncology in general and specifically for prostate cancer are targeting NTRK mutations. So, NTRK I, II, and III, those are genes that can get mutated in any cancer type.   

And just like the example of immunotherapy with microsatellite instability, the same holds true. So, any cancer with an NTRK mutation, there is an FDA approval to use NTRK inhibitory oral medications to treat that patient. Similarly to immunotherapy and microsatellite instability, we wish those mutations were more common because the treatment is very well-tolerated and is incredibly effective.  

But still, just because it’s not common doesn’t mean we shouldn’t look for it because of how impactful these treatments can be. 

When Should Breast Cancer Patients Consider a Clinical Trial?

When Should Breast Cancer Patients Consider a Clinical Trial? from Patient Empowerment Network on Vimeo.

Is there a point in a patient’s breast cancer care when a clinical trial should be considered? Breast cancer expert Dr. Bhuvaneswari Ramaswamy shares her perspective.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about Dr. Ramaswamy.

See More from Breast Cancer Clinical Trials 201

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Transcript:

Katherine: 

Let’s talk about where clinical trials fit into a breast cancer treatment plan. When should someone with breast cancer consider a trial? 

Dr. Ramaswamy:

And the most important thing again here to understand is clinic – you should consider a clinical trial at all aspects, all parts of your journey through this whole diagnosis and whatever the outcomes that you are going to have. We all have a lot of misconstrued ideas about clinical trials. And one of the thing is we think clinical trials are only when standard of care is not needed like that is that – we don’t have other treatments. That you are coming to a point that you don’t have other treatments and now you should go to clinical trials. That is not true, right? Because the fact that you can have these treatments in your curative setting came because many of the patients before you were willing to go on the trial that compared standard of care, which may not have had that new drug with a competitor to the new drug with the standard of care.  

So, nobody gives – the important thing to understand is no one is going to give you a placebo alone for cancer treatment. Think about that. I mean, there’s no way a doctor whose oath is to cure you to help you is going to just give you placebo. So, it is important for you throughout your process to actually ask. In fact, we used to wear a badge to say ask your doctor about clinical trials. So, ask your doctor about it, even if they miss it. Just ask, is there a clinical trial that I could fit in? They’re supposed to look for it, but you don’t need to leave it at that.  

Ask at all aspects of your journey for a clinical trial option. If you are not suited for the trial, no provider is going to put you on that trial because everybody   has  the same goal that you need to get better. Your  chances of getting better is high. 

Three New Developments in Prostate Cancer Care

The goal of PEN’s TelemEDucation Empowerment Resource Center is to significantly improve Prostate Cancer patients’ and caregivers’ familiarity with remote access to healthcare, and thus increase quality of care regardless of geographical location. 

This one-of-a-kind resource center is intended to educate the prostate cancer community on the practical usage of telemedicine tools, to humanize patient and provider experiences.

With the emergence of telemedicine in the prostate cancer care toolbox, we have published our Patient Empowerment Network (PEN) Telemedicine Specialized Care Directory, Prostate Cancer Edition and Directorio de Atención Especializada de Telemedicina: Edición del cáncer de próstata in both English and Spanish for prostate cancer patients and care partners. The downloadable and printer-friendlt information-packed guides contain valuable resources for navigating prostate cancer with the assistance of telemedicine including:

  • Telemedicine videos with prostate cancer expert Dr. Heather Cheng
  • Advice for connecting to specialized prostate cancer care
  • Resources to locate and evaluate doctors
  • Information about mobile-optimized tools, artificial intelligence (AI), next-generation sequencing, and telegenetic consultations

For prostate cancer patients and care partners who can learn optimally in Spanish, these individuals have an additional option. The telemedicine resources are also provided in Spanish for learning more about telemedicine care.

Now here’s a look at the summary of latest developments in prostate cancer care.

What are the latest developments in prostate cancer, and how can patients and care partners be assisted in navigating their journeys through care? In the “New Developments in Prostate Cancer Care” program, expert Dr. Heather Cheng from Seattle Cancer Care Alliance shares three key developments in prostate cancer care. These developments were presented at one of the top annual meetings of oncologists – the American Society of Clinical Oncology (ASCO) 2022 annual meeting.

1. Advanced Prostate Cancer Treatment for Early Stages

Prostate cancer researchers are studying the results of using advanced prostate cancer combination treatments for patients in earlier stages. The approach uses the theory that the drug combinations will be even more effective when they used earlier in disease progression and before patients have become very sick. Immunotherapy is one of the treatments under study in combination treatments earlier in progression of prostate cancer. With immunotherapy, a patient’s own immune system is harnessed and used to fight against cancer.

2. Precision Oncology

Precision oncology is a research development to use tailored therapy for prostate cancer treatments. An array of key factors are examined to tailor treatment for optimal patient care, including factors like cancer genetics, patient genetics, overall health, co-morbidities, and possibly others. In using the more personalized therapy, prostate cancer patients should experience a higher quality of life during treatment and improved health outcomes.

3. Targeted Radiation Therapies

Targeted radiation therapies and a new treatment called lutetium (Pluvicto) take a more focused treatment approach that avoids damage to non-cancer cells. With lutetium, the treatment seeks out cells that express the prostate-specific membrane antigen (PSMA). If PSMA is expressed, lutetium treatment attacks those cells and bypasses healthy cells where PSMA is not expressed.

By staying updated on the latest developments in prostate cancer care, patients and care partners can gain knowledge and confidence to talk with their doctors about care that may be best for them or for their loved one. If you want to expand your knowledge, check out our prostate cancer information.

See More From Prostate Cancer TelemEDucation

How Is Genetic Information Used for Prostate Cancer Treatment?

How Is Genetic Information Used for Prostate Cancer Treatment? from Patient Empowerment Network on Vimeo.

Prostate cancer can impact patients differently depending on their risk group. Dr. Heather Cheng from Seattle Cancer Care Alliance explains how genetic information is used in prostate cancer treatment and other factors that can impact patient outcomes.

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Prostate Cancer Genetic Testing and Family Testing Guidelines

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Telemonitoring and How It Benefits Prostate Cancer Patients 

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Transcript:

Sherea Cary:

Can you speak to how you and your colleagues are using genetic information to help with the treatment and understanding prostate cancer for different risk groups?

Dr. Heather Cheng:

Yeah, thank you that…that’s something that I think is following the lines of this idea of precision oncology or tailoring. Tailoring people’s management, either if they don’t have cancer and we’re worried about the risk of cancer, we can use genetic markers that we can test from saliva or blood to help understand that person’s risk of prostate cancer better, and in some cases, there are some families where there are markers or genes that run in the families that might increase the risk of developing prostate cancer, but also sometimes the same genes are increased the risk of breast cancer and ovarian cancer, and if they’re present, then it’s important to think about knowing that, getting that information, because then there are strategies that we can use to find it earlier and to treat it more aggressively and hopefully have much better outcomes in a much better likelihood of curing prostate cancer. But then also the other related cancer, so for men, this is really important because we haven’t previously been thinking about it in the same way, but that’s one example of how genetics can affect the thinking about the risk of prostate cancer. We know that Black men have a higher risk of prostate cancer to begin with, and we were beginning to understand why that might be.

Some of it may be genetic, some of it may be access to healthcare and knowledge, which we’re trying to help disseminate the knowledge here, and then sometimes it’s care delivery, so we want to focus on all of those things, but genetics are part of that.

Could Genetic Mutations Impact Your Prostate Cancer Treatment Options?

Could Genetic Mutations Impact Your Prostate Cancer Treatment Options? from Patient Empowerment Network on Vimeo.

Can prostate cancer treatment options be impacted by a patient’s genetic mutations? Expert Dr. Tomasz Beer defines precision oncology and explains how DNA repair and mutations can affect treatment options.

Dr. Tomasz Beer is Deputy Director at OHSU Knight Cancer Institute. Learn more here: https://www.ohsu.edu/people/tomasz-m-beer-md-facp.

See More From INSIST! Prostate Cancer

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Why Should You Ask Your Doctor About Prostate Cancer Genetic Testing?

Why Should You Ask Your Doctor About Prostate Cancer Genetic Testing?

The Link Between Prostate Cancer and Genetic Mutations

The Link Between Prostate Cancer and Genetic Mutations

Prostate Cancer Treatment Decisions: How Do Genetic Test Results Impact Your Options?

Prostate Cancer Treatment Decisions: How Do Genetic Test Results Impact Your Options?


Transcript:

Katherine:

Are there genetic mutations that affect the choices for prostate cancer treatment?

Dr. Beer:                     

Increasingly so. So, this is an exciting era in terms of those kinds of approaches. You may have heard the term “precision oncology” or “personalized oncology.” The ideas behind precision oncology is that each individual patient’s tumor is analyzed in detail for their biologic differences, and for the most part, those are mutations; although, it can be other. And that treatments may be available that work particularly well for patients whose cancers have a particular mutation. And so, today, there are a couple of categories of treatments that are FDA-approved and that can be used in prostate cancer treatment if the right mutations are present.

And one of those is a class of drugs called PARP inhibitors and those are indicated in patients with advanced prostate cancer who received some of our most commonly used routine treatments and who harbor mutations in a series of genes that are responsible for DNA repair. BRCA-2 or BRCA-2 is the most common of those, and that may be a gene that is familiar to people because it’s also a significant gene in terms of conferring risk of breast and ovarian cancer.

So, that’s the same gene we’ve been thinking about for breast cancer is also important in prostate cancer. There are other DNA repair genes as well that may sensitize a cancer to PARP inhibitors. Another area is something called microsatellite instability, which is a measure of how mutation prone a cancer is.

And cancers that acquire a large number of mutations are more likely to respond to immune therapies. And one might ask why that is, and it’s an interesting question. We believe it’s because, as a large number of mutations accumulate, we see more and more abnormal proteins that are made from those mutated genes, and those abnormal proteins, some of them are different enough from our native proteins, to cause the immune system to recognize them. And when we have an immune system that actually recognizes our cancer as foreign, we’re often able to amplify that immune signal and turn it into a potent anticancer weapon.

So, those are the two categories of mutations that we use in the clinic today, DNA repair and this microsatellite instability, but others are coming as we develop more targeted, specific agents designed for people with specific cancers who have specific mutations.

Katherine:                  

Dr. Beer, why should prostate cancer patients ask their doctor about genetic testing?

Dr. Beer:                     

Well, there are a couple main reasons for that. One is, of course, to examine their cancer and determine if they’re eligible for one of these targeted therapies. If we find those mutations, those patients have an extra treatment available to them. They can still be treated with all the hormonal therapies, chemotherapy, radiation-based treatments, but in addition to those, they have an additional targeted option. And so, that’s a real advantage for those patients who harbor those mutations. So, that’s really reason number one reason, number two is to potentially protect their families.

So, if a germline mutation is identified, that mutation can be passed on to kids. It may also be in other family members, brothers and sisters, and potentially be passed onto their kids. Important to understand that these mutations, as I alluded to earlier, are not just prostate cancer mutations. They can be passed through the mother. They can predispose folks to bre  ast cancer. So, a germline mutation may be something the family would benefit from knowing about. It’s a complicated area, learning about inherited cancer mutation in the family, could be very stressful and frightening.

So, I wouldn’t say this lightly. I think it needs to be done within the context of genetic counseling and good advice about how to communicate things like that and what to do with them. We want to be able to help people reduce their risk of cancer without taking an emotional toll on multiple members of the family.

So, it’s important, and it’s also important to do it thoughtfully and carefully.