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    Breast Cancer Treatment Center

    Metastatic Breast Cancer Program

    Treating patients with metastatic breast cancer is a significant part of our practice at the Susan F. Smith Center for Women's Cancers. Our doctors, nurses, research staff, social workers, and others provide continuous care, support, and assistance. We are committed to providing each patient with the best and most personalized treatment options available, taking advantage of the full range of services of a top-ranked cancer hospital and research center.

    About Metastatic Breast Cancer

    When breast cancer spreads to other parts of the body, such as the bones, brain, liver, or lungs, it is called metastatic (also referred to as advanced or stage IV).

    Although it is not curable, metastatic breast cancer can be treatable. Today, with new therapies, including biologic targeted treatments and novel drug combinations, women with metastatic breast cancer can live well for many years. Through our overarching metastatic breast cancer program, called EMBRACE (Ending Metastatic Breast Cancer for Everyone), our experts offer standard therapies and lead multiple clinical trials for each subtype of metastatic breast cancer.

    We have a greater number of metastatic breast cancer patients, and offer more clinical trials, than any other cancer center in New England. We offer ongoing educational opportunities for referring physicians as well as patients. We also conduct a longitudinal study (also called EMBRACE) on outcomes for women with metastatic breast cancer.

    Just as we create a personalized treatment approach for your specific type of cancer, we also design an individual plan of care and support for you and your loved ones, based on your goals and values.

    Near or far, we are here for you

    As partners in your treatment, our care team can also collaborate with you and your local oncologist during the course of your treatment if you live a distance away. Near or far, we are here to provide active, continuous care to help you achieve the highest possible quality of life and make informed decisions about your care.

    Dr. Eric Winer on Metastatic Breast Cancer

    Metastatic breast cancer is a stage of breast cancer that has moved to other parts of the body. Eric Winer, MD, director of Breast Oncology at the Susan F. Smith Center for Women's Cancers, describes metastatic breast cancer symptoms, treatment options and prognosis.

     

    Compassionate Clinical Care, Comprehensive Support Services

    nurse with a metastatic breast cancer patient

    Our care team works closely with each patient, providing the expertise and collaboration of many specialists. Experts from medical oncology, surgical oncology, and radiation oncology coordinate your care to ensure that you will receive the combination of treatments that is best for you, and enjoy the best possible quality of life.

    In addition to medical, surgical, and radiation oncologists and nurses, your care team can include social workers, nutritionists, psychologists and psychiatrists, exercise physiologists, integrative therapists (acupuncturists, massage therapists), and others.

    Learn more about how we treat breast cancer.

    An outreach coordinator meets EMBRACE patients on their first day, outlines the services available to them, and guides them at every step. These services include integrative therapies, support groups, and peer mentorship.

    We offer patient- and family-centered care, which means that you and your family are the focus of our attention. Your health care team will take the time to listen, understand your needs and preferences, and help give you a better sense of control over your life.

    Learn more about our breast cancer support services.

    The Patient Experience

    Although there is no cure for metastatic breast cancer, it is very treatable. Thanks to new therapies developed through clinical trials, women and men with metastatic breast cancer often lead full, active lives.

    Still, living with incurable cancer takes a certain kind of courage and resolve. The following individuals share their insights into what they've learned and into what keeps them grounded, purposeful, and happy as they go about their day-to-day lives, living with metastatic breast cancer.


    Duncan Finigan

    "I choose to call it treatable, non-curable cancer. On my first appointment they told me, 'You're going to live for many, many years. We have solutions to deal with your cancer. You have a chronic disease, like diabetes.'" 

    Watch a video of Duncan Finigan telling her story at the Susan F. Smith Center for Women's Cancers Executive Council Breakfast.

    Duncan Finigan 


    Lise Pass

    "You have to empower yourself against cancer, to think of it as an uninvited guest. You may need to live with it, but you can't let it encompass you. I am a 55-year-old wife and mother who cares for children who need me. I am so much more than the cancer." 

    Read about Lise Pass — a foster parent of 48 children —- who has been living with metastatic breast cancer for nearly a decade.

    Lise Pass 


    Kiara Kharpertian

    "You wouldn't think that sitting in an infusion room at Dana-Farber's Susan F. Smith Center for Women's Cancers would lend itself to addressing hurried save-the-date envelopes or sketching centerpiece designs, but that is exactly what I did over the next three months." 

    Read Kiara Kharpertian's account of meeting her husband-to-be, falling in love, and planning their wedding after her diagnosis of metastatic breast cancer.

    Kiara Kharpertian 


    Meg McCormick

    "When I learned I had a stage IV breast cancer, I decided not to let it rob me of the opportunities to enjoy my life. I still have a physically active, socially engaged lifestyle, and if you have metastatic breast cancer, so can you." 

    Read about Meg McCormick's cancer journey and the people, experiences, and attitude that fuel her zest for life.

    Meg McCormick 


    Michael Selsman

    "Men don't have the opportunities to find breast cancer during a routine check-up like women do. I want to change that, and save other families from the pain and challenge of living with stage IV male breast cancer." 

    Read about Michael Selsman's efforts to raise awareness of male breast cancer and the genetic risks that run in some families — including his.

    Michael Selsman 

    Clinical Trials for Metastatic Breast Cancer

    Because we recognize that metastatic breast cancer is not just a single disease, we personalize clinical trials to each patient's type of cancer and diagnosis, matching patients with the trial that is the most compelling and relevant for their kind of breast cancer. We are conducting multiple clinical trials to study the effect of new targeted drugs, particularly in patients with metastatic disease. Much of the research work performed at Dana-Farber has resulted in treatment breakthroughs and new standards of care for patients with metastatic disease.

    See our full list of clinical trials for metastatic breast cancer.

    Should you participate in a clinical trial?

    Participating in a clinical trial is a very personal decision, and a choice that is completely yours to make. If it feels right to you, there are several good reasons to participate:

    • Clinical trials are how we make progress against cancer.
    • Over the past decade, thanks to participating patients, a number of new drugs have been approved for treatment of metastatic breast cancer.
    • Taking part in a clinical trial can offer you new treatment options.
    • By participating in a clinical trial, you contribute to knowledge that can help future patients.

    Learn more about clinical trials and whether participating in a clinical trial is right for you.

    EMBRACE Study

    Ending Metastatic Breast Cancer for Everyone (EMBRACE) is a research study conducted at Dana-Farber Cancer Institute. This study began recruiting patients in 2009, with the aim of learning more about the biology of advanced breast cancer, as well as the treatment experiences of patients living with it.

    Each patient's progress is tracked by a study coordinator, and the information collected is used to help doctors understand more about the long-term journey of the metastatic breast cancer patients in this group. Investigators hope the study will bring them closer to finding a cure for this disease.

    The study also sponsors a metastatic breast cancer forum every year, as well as webcasts of topics relevant to patients with metastatic disease.

    The study is not sponsored by drug companies, and patients are not required to be on any drug trials.

    For more information on EMBRACE, please email embrace@partners.org.

    Research Advances in Metastatic Breast Cancer

    Research is particularly vital when it comes to cancer that has spread beyond the breast (metastatic). One hallmark of the Susan F. Smith Center for Women's Cancers is the integration of research and patient care, and the equal investment in both. At a basic level, scientists seek to understand the basic biology of how and why breast cancer can spread, and at a clinical level, clinician/scientists test potential therapies in patients. More than 30 clinical trials are now underway for women with metastatic breast cancer.

    Research conducted through the Specialized Program of Research Excellence (SPORE) led by Eric Winer, MD, encompasses several metastatic breast cancer projects. This prestigious five-year grant funded by the National Cancer Institute includes projects aimed at identifying drug "targets" on breast cancer cells.

    Here are some examples of our current metastatic breast cancer research advances.

    Clinical Trials

    • Numerous trials focus on metastatic breast cancer that is driven by the hormone estrogen. A promising candidate for treating such "ER-positive" tumors is a class of drugs known as PI3-kinase (or PI3K) inhibitors, which inhibit a pathway that is often overactive in these cancers. A recent phase 2 trial led by Ian Krop, MD, PhD, showed that adding a PI3K inhibitor to a hormone blocker may partially restore the blocker's effectiveness and delay the advance of the disease.
    • ER-positive, metastatic breast cancer is often characterized by unregulated cell growth and division, a process linked to an oversupply of the protein cyclin D. Drugs known as CDK4/6 inhibitors block cyclin D, and stop tumor cell growth. A recent phase 1 clinical trial led by Sara Tolaney, MD, MPH, found that a CDK4/6-inhibiting drug called abemaciclib caused tumors to shrink or stop growing in one-third of participants with ER-positive metastatic breast cancer.
    • A phase 2 clinical trial led by Beth Overmoyer, MD, found that a daily dose of the drug enobosarm shows promise for women with metastatic breast cancer that is driven by both estrogen and androgen. One advantage of the drug is that it produces even milder side effects than those associated with standard hormonal therapy.
    • Ian Krop, MD, PhD, Sara Tolaney MD, MPH, Eric Winer, MD, and their colleagues have launched a series of clinical trials of drugs designed to unleash an immune system attack on triple-negative breast cancer that has metastasized. (Triple-negative breast cancer cells lack the HER2 receptor, as well as receptors for the hormones estrogen and progesterone.) The drugs target PD-1, a protein on immune system cells that normally restrains them from attacking cancer cells. Although the initial trial is still underway, the approach is showing promise and has led to the additional studies, a welcome sign in a disease where long-lasting results have been difficult to attain with chemotherapy.
    • Susan F. Smith Center researchers are also focused on metastatic breast cancer fueled by the presence of the growth-promoting protein HER2. Nancy Lin, MD, and her colleague Otto Metzger-Filho, MD, have launched a phase 1 clinical trial of the drugs ARRY-380 and T-DM1 in patients with HER2-positive breast cancer that has metastasized to the brain.

    Basic Research

    • Hormonal therapy, which deprives ER-positive breast cancers of estrogen, is part of after-surgery therapy for early ER-positive breast cancer, and is often successful at preventing return of the disease. However, ER-positive breast cancer can recur many years later, often at a site far from the original tumor. Researchers led by Myles Brown, MD, have discovered that breast tumor cells can carry an abnormal "receptor" for estrogen, potentially allowing them to grow even when estrogen is absent. Researchers hope to use this finding to guide the development of new drug agents.
    • Brown and his colleague Rinath Jeselsohn, MD, are studying a particularly promising class of drugs for metastatic, ER-positive breast cancers. Known as selective estrogen receptor degraders (or SERDs), they clamp onto the estrogen receptor and cause it to crumble, so the tumor cells no longer respond to estrogen.
    • Other research is focusing on the molecular makeup of breast tumors — the presence of genetically distinct cells within a single tumor. Tumors with the most "heterogeneity" — the greatest diversity of cell types within them — are often more likely to resist treatment and to metastasize. Researchers led by Kornelia Polyak, MD, PhD, have discovered that the fastest-proliferating cells within a tumor aren't necessarily the main drivers of tumor growth, suggesting that efforts to develop new drugs should focus on targeting the actual driver cells.
    • Up to 50 percent of HER2-positive breast cancers spread to the brain, but scientists have known little about how the process occurs. Recently a team of researchers including Nikhil Wagle, MD, Eric Winer, MD, Ian Krop, MD, PhD, Jean Zhao, PhD, Nancy Lin, MD, and Shom Goel, MD, PhD, found that approximately 12 percent of such tumors contain mutations that may explain why they don't respond well to the target drug trastuzumab, also known as Herceptin. Researchers in Zhao's lab have implanted patients' metastatic tissue into animal research models, making it possible to test various drugs to see which may be most effective against the disease.
     

    Contact Us

    To find out more about our metastatic breast cancer expertise and resources, please contact one of our nurses at 617-632-3478.

     
     
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