Teresa Wallace, 52, is an accountant from Alton, Texas, in the Rio Grande Valley. She is working less with numbers and doing far fewer craft projects after being diagnosed with HER2-positive breast cancer in 2013. Her treatment started with a single mastectomy and breast reconstruction surgery, but there was an infection and the cancer came back. It spread to her right breast, then her lungs and now to her brain.
In addition to surgery, Wallace has had radiation and chemotherapy. “I’ve had 17 procedures since this all started,” said Wallace, a mother of six children and grandmother of three, counting her husband’s family.
However, Wallace also is a fighter. She works daily to maintain a positive attitude. And she and her husband now drive four hours every three weeks for her to receive treatment at UT Health Cancer Center, part of UT Health San Antonio. She is participating in a clinical trial of a new drug for HER2-positive breast cancer led by Andrew Brenner, M.D., Ph.D., a breast and brain cancer oncologist and researcher at UT Health.
HER2-positive breast cancer is one of the most aggressive types of breast cancer. Patients with this type of breast cancer usually have shorter survival, a greater chance of recurrence and the likelihood that the cancer will spread to the brain and other areas of the body.
“In HER2 breast cancer, there is too much of a protein called human epidermal growth factor receptor 2 (HER2) on the outside of the cancer cells. This causes the cancer to metastasize, or spread, more quickly to other parts of the body,” Dr. Brenner said.
Over the past 20 years, four medications have been developed to treat HER2 breast cancer: trastuzumab, pertuzumab, ado-trastuzumab emtansine and lapatinib.
“Even with these advances, new therapies are needed because existing therapies targeting HER2-positive breast cancer eventually fail, even if they do provide some very significant improvement in survival. The need is even more pressing for patients whose cancer has spread to the brain. There are very few therapies that can target these proteins and that can get past the blood vessels that supply the brain and the critical blood-brain barrier. Therefore, the brain is one of the most likely sites for the cancer to go, because the treatments we have are not able to access the brain to treat the cancer,” Dr. Brenner explained.
“For this reason, patients with brain metastases are not included in most clinical trials because there often is inadequate evidence that the medications enter the brain, and there is concern that effects from the cancer could be attributed to the drug instead of the progression of the cancer. We believe this new drug we are investigating could be an answer for patients with progression of the disease to the brain,” he said.
As part of being an academic health science center and one of only National Cancer Institute-designated cancer centers in Texas, UT Health Cancer Center conducts approximately 150 clinical trials at any given time for various types of cancer. The clinical trial Wallace is participating in evaluates a new drug called tucatinib, an oral medication that can be taken at home.
“We are seeking more participants,” Dr. Brenner said. During this study, participants who have HER2-positive breast cancer that has spread to the brain and otherwise qualify, will receive standard, approved treatments. Some also will receive the investigational drug tucatinib, to compare which approach works best for patients.
“The goals of these clinical trials are to find better treatments that will give doctors and patients more options to personalize treatment to the patient, to improve the patient’s quality of life and ultimately, to save more lives,” Dr. Brenner said.
To learn more about this and other cancer clinical trials at the UT Health Cancer Center, please call 210-450-1000.
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