Duke University Durham, North Carolina
Co-Director, Breast Clinical Research Unit Professor, Radiation Oncology Duke University Durham, North Carolina
Testing the effect of radiation in combination with immunotherapy to prevent breast cancer recurrence.
Despite significant advances in the management of breast cancer, mortality remains unacceptably high in some more aggressive forms of the disease. For breast cancer patients who remain at high risk for relapse with standard therapy, harnessing the immune system prior to surgery has the potential to induce a lasting anti-tumor immune response, and improve outcomes. Thus far, immunotherapy in the pre-operative (neoadjuvant) setting has shown promise in triple-negative breast cancer (TNBC), yet many patients only achieve a partial response. Radiation alone can induce an immune response to the tumor, as dying tumor cells release immune-stimulating components and may therefore be a valuable addition to immunotherapy. Dr. Ho and her colleagues initiated P-RAD, a clinical trial offering combination pre-operative radiation therapy (RT), immunotherapy and pre-operative chemotherapy treatment for patients with TNBC or hormone receptor(HR)-positive/HER2-negative breast cancer who have a high risk of disease recurrence. Based on support from BCRF, the study recently received an NIH award to expand P-RAD and study the effect of RT and immunotherapy on the outcome of pathologic complete response.
The study is open at five institutions: Massachusetts General Hospital (lead site), Dana-Farber Cancer Institute, Johns Hopkins University Cancer Center, Memorial Sloan Kettering Cancer Center, and Montefiore Cancer Center. The study also expanded: to accumulate 80 TNBC patients, and to add a second cohort of 48 high-risk HR-positive breast cancer patients.
This study’s goal is to find the safest, minimum dose of RT required to ultimately make immunotherapy and chemotherapy more effective. It will also study the effects of the therapy on patient quality of life and investigate potential biomarkers, using blood and tumor samples to be able to identify which patients are most likely respond to this therapeutic strategy.
Alice Ho, MD, MBA is Co-Director of the Breast Clinical Research Unit and Professor of Radiation Oncology at Duke University. Her clinical practice focuses solely on the treatment of breast cancer patients, and as a physician investigator her research focuses on identifying opportunities for enhancing outcomes in high-risk breast cancer patients by combining radiation with rational, biologically focused therapies such as immunotherapies and DNA repair-based agents to improve the efficacy of radiation.
Nationally, Dr. Ho serves as an expert member of the Breast Cancer Committee for Society for Immunotherapy of Cancer, and she has also served as a panel member in the development of several national and international consensus statements and guidelines for radiation therapy for breast cancer through ASTRO and ASCO. She is deeply committed to teaching residents and fostering educational initiatives, serving as an academic mentor to numerous trainees and serves as the Chair of the Written Board Examinations in the American Board of Radiology.
Dr. Ho received her MD, MBA from Tufts University School of Medicine and completed residency training in Radiation Oncology at Mount Sinai Medical Center.
2020
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