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Metastatic Breast Cancer Clinical Research and Trials

  • Nancy Lin, MD (left), and Erica Mayer, MD, MPH

    Nancy Lin, MD (left) and Erica Mayer, MD, MPH

  • 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.

    If you're living with metastatic breast cancer, view a video webchat with experts Nancy Lin, MD, and Erica Mayer, MD, MPH, on choosing a clinical trial for metastatic breast cancer.

    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 recently completed enrollment to a phase 1 clinical trial of the drugs ARRY-380 and trastuzumab (Herceptin) in patients with HER2-positive breast cancer that has metastasized to the brain, and final results are expected later in 2017.

    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.