Identifying patients who benefit most from immune suppressant

May 3, 2012, European Society for Medical Oncology

A new analysis may help doctors identify breast cancer patients who will benefit from treatment with the immune suppressant drug everolimus, say French researchers at the 4th IMPAKT Breast Cancer Conference in Brussels, Belgium.

Everolimus is currently used as an to prevent patients rejecting transplanted organs and in the treatment of . Research is also being conducted into the drug's use in other cancers, including .

Dr Thomas Bachelot, from Centre Leon Berard in Lyon and colleagues analyzed data from the TAMRAD study, published two years ago[1]. This was the first study to show that in patients whose cancer progressed after treatment with the drug tamoxifen, the time-to-progression could be delayed by the addition of everolimus.

The new study aimed to identify which biological characteristics of the patient's primary tumor could be used to identify those for whom everolimus would be most effective. "This is of great importance, as everolimus is quite toxic and you don't want to give this drug if you're not sure the patient will benefit from it," Dr Bachelot explained.

"The interesting thing is that we did not find what we expected," Dr Bachelot said. The researchers had hypothesized that patients who would benefit the most from this treatment would be those with high expression levels of phosphatidylinositol 3-kinases (or PI3Ks), a family of enzymes involved in cellular functions such as cell growth and proliferation.

"But the opposite seems to be true," Dr Bachelot said. In patients with low PI3K levels, median time-to-progression exceeded 30 months, while in those with high levels, median survival was 6.4 months.

"At the same time, we also found that the low expression of a protein that normally block mTOR activation, LKB1, was associated with a good response to everolimus, while patients with normal levels of this protein did not have the same good response. Those results suggest that patients with an activation of mTOR that is not dependent on PI3K are the ones who may benefit the most from everolimus."

"These are exiting results, as they may allow for a better selection of patients who should receive this very effective but sometimes toxic drug," Dr Bachelot said. The results need to be validated on an independent and larger cohort of patients before any definitive conclusion can be reached, he noted. The researchers hope this will be done in coming months.

Commenting on the study which he was not involved in, Dr Angelo Di Leo, from Hospital of Prato, Italy, former IMPAKT Co-Chair, said: "These are very attractive results, but still preliminary. For the time being we do not have molecular markers that can be used in clinical practice to select patients candidate to this treatment. It will be important to test the identified markers of response to everolimus, in particular PI3K, in the context of the recently presented large phase-III trials."

Explore further: New hope for advanced post-menopausal breast cancer patients resistant to hormonal therapy

Related Stories

New hope for advanced post-menopausal breast cancer patients resistant to hormonal therapy

September 26, 2011
Results from a phase III clinical trial have shown that combining two existing cancer drugs to treat post-menopausal women with advanced breast cancer resistant to hormonal therapy significantly improves outcome. Researchers ...

PI3K/mTOR pathway proteins tied to poor prognosis in breast cancer

April 1, 2012
Four proteins involved in translation, the final step of general protein production, are associated with poor prognosis in hormone-receptor-positive breast cancer when they are dysregulated, researchers reported at the AACR ...

Combination of everolimus and exemestane improves survival for women with metastatic breast cancer

December 8, 2011
In an international Phase III randomized study, everolimus, when combined with the hormonal therapy exemestane, has been shown to dramatically improve progression-free survival, according to research from The University of ...

Everolimus plus exemestane improves bone health in post-menopausal women with advanced breast cancer

March 23, 2012
Results from a phase III clinical trial evaluating a new treatment for breast cancer in post-menopausal women show that the combination of two cancer drugs, everolimus and exemestane, significantly improves bone strength ...

Recommended for you

How cancer metastasis happens: Researchers reveal a key mechanism

January 18, 2018
Cancer metastasis, the migration of cells from a primary tumor to form distant tumors in the body, can be triggered by a chronic leakage of DNA within tumor cells, according to a team led by Weill Cornell Medicine and Memorial ...

Modular gene enhancer promotes leukemia and regulates effectiveness of chemotherapy

January 18, 2018
Every day, billions of new blood cells are generated in the bone marrow. The gene Myc is known to play an important role in this process, and is also known to play a role in cancer. Scientists from the German Cancer Research ...

These foods may up your odds for colon cancer

January 18, 2018
(HealthDay)—Chowing down on red meat, white bread and sugar-laden drinks might increase your long-term risk of colon cancer, a new study suggests.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.

Researchers develop swallowable test to detect pre-cancerous Barrett's esophagus

January 17, 2018
Investigators at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center have developed a simple, swallowable test for early detection of Barrett's esophagus that offers promise ...

Scientists zoom in to watch DNA code being read

January 17, 2018
Scientists have unveiled incredible images of how the DNA code is read and interpreted—revealing new detail about one of the fundamental processes of life.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.