Cesar Santa-Maria, MD, MS

Optimizing treatments for patients with triple-negative breast cancer.

Impact

Triple-negative breast cancer (TNBC) is a particularly aggressive form of breast cancer. While combining immunotherapy with chemotherapy before surgery has improved responses and reduced recurrence, the current treatment regimen can cause severe side effects and does not benefit all patients. For this reason, there is a need to assess tumor response early in treatment so that adjustments can be made to the therapy. Emerging evidence suggests that FDG-PET imaging and circulating tumor DNA (ctDNA) after just three weeks of therapy may predict which patients will experience a pathologic complete response (pCR), showing no signs of cancer at surgery.

Progress Thus Far

For his Conquer Cancer Award supported by BCRF, Dr. Santa-Maria will investigate if changes in FDG-PET scans and ctDNA can predict pCR by testing patients with early-stage TNBC before and after three weeks of immunotherapy plus chemotherapy. To date, he and his team have enrolled 20 patients to the NeoADAPT trial, a pilot study seeking to answer this question. Of the patients who have completed surgery, 75 percent have achieved pCR, demonstrating early evidence of efficacy and feasibility of this approach.

What’s next

Dr. Santa-Maria’s trial will serve as a platform for tissue, blood, and imaging analysis to help identify responders to therapy. He and his team will continue collecting samples and information as the trial completes accrual, potentially reducing unnecessary treatment and associated side effects while improving outcomes in patients with triple-negative breast cancer.