Road to a Cure - ADC & SARM

In this fifth episode in our Road to a Cure series, the team meets up with renowned hematologist oncologist, Dr. Hope Rugo of USCF's Carol Franc Buck Breast Care Center. Dr. Rugo is also co-director of UCSF's breast cancer clinical trials program. She is also an investigator with the Bay Area's SPORE (Specialized Programs of Research Excellence) on breast cancer. 

Co-hosts Victoria Goldberg and Dr. Ellen Landsberger take some time to unpack Dr. Rugo's view of what a cure looks like for metastatic cancers, the exciting leadership shown with dosing, and a very clear review of the latest treatments and upcoming clinical trials that could help those with both triple-negative and hormone-positive breast cancer.

Dr Rugo is principal investigator for many clinical trials focusing on combining immunotherapy and targeted therapeutics with standard treatment to improve treatment of metastatic breast cancer. Most recently, she was the lead researcher of the ASCENT trial ( cited below) which excited oncologists and patients alike with the improvement in progression-free and overall survival in those treated with the antibody drug conjugate sacituzumab govitecan than with single-agent chemotherapy among patients with metastatic triple-negative breast cancer.

In addition to her leadership in multiple drug trials, Dr Rugo has taken a keen interest in reducing toxicity from treatment of cancer. She participated in the development of scalp cooling to reduce hair loss from chemotherapy and a steroid mouthwash to reduce stomatitis. 

We were not surprised to learn that Dr Rugo is the recipient of multiple awards both for excellence in patient care and education of patients and medical professionals alike. Both Victoria and Ellen learned so much during our interview session and we are excited to share this episode with you. 

Episode Notes

Triple-Negative Breast Cancer

Gene Expression Profiling

Gene Expression Profiling for Diagnosis of Triple-Negative Breast Cancer: A Multicenter, Retrospective Cohort Study

Gene expression analysis to detect disseminated tumor cells in the bone marrow of triple-negative breast cancer patients predicts metastatic relapse.

TNBC and Racial Disparities

• Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors

• ASCO President’s Address on Equity in Cancer Care, August 15, 2021 

• Navigating a Path to Equity in Cancer Care: The Role of Patient Navigation

Treatment for Metastatic Triple Negative Breast Cancer 

Sacituzumab Govitecan is an antibody drug conjugate ( ADC) that was recently approved by the FDA for treatment of metastatic Triple Negative Breast Cancer. This ADC combines a potent chemotherapeutic agent with an antibody that is recognized by a unique cellular protein on the cancer cell that is not expressed on healthy cells, allowing this “smart bomb” to enter the cancer cell and kill it with minimal damage to healthy cells.  

• Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer

• A plain language summary of the ASCENT study: Sacituzumab Govitecan for metastatic triple-negative breast cancer

• Biomarker analyses in the phase III ASCENT study of sacituzumab govitecan versus chemotherapy in patients with metastatic triple-negative breast cancer

 Immunotherapy

• An Overview of PARP Inhibitors for the Treatment of Breast Cancer

• Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer

• Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer

Selective Androgen Receptor Modulators: SARMS

• Selective androgen receptor modulators (SARMs) negatively regulate triple-negative breast cancer growth and epithelial:mesenchymal stem cell signaling

• Development of selective androgen receptor modulators (SARMs)

• A Phase II Clinical Trial of Pembrolizumab and Enobosarm in Patients with Androgen Receptor-Positive Metastatic Triple-Negative Breast Cancer

• Androgen Receptor: A Complex Therapeutic Target for Breast Cancer

Scalp Cooling

Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer

Mouthwash to Prevent Stomatitis

Prevention of everolimus/exemestane (EVE/EXE) stomatitis in postmenopausal (PM) women with hormone receptor-positive (HR+) metastatic breast cancer (MBC) using a dexamethasone-based mouthwash (MW): Results of the SWISH trial

Mentioned in this Series

• The Future of Metastatic Breast Cancer Treatment Is Bright  (HealthCentral, 2020) 

• Sledge (2016) Curing Metastatic Breast Cancer

• Wang (2019) Long-Term Survival of De Novo Stage IV Human Epidermal Growth Receptor 2 (HER2) Positive Breast Cancers Treated with HER2-Targeted Therapy

• 2020 EMBRACE MBC Virtual Form Series - Welcome Session

• Susan G. Komen Breast Cancer Statistics