Brigham and Women’s Hospital
Rob and Karen Hale Distinguished Chair in Surgical Oncology
Improving outcomes for patients with triple-negative breast cancer receiving immunotherapy.
Immunotherapy is now approved for routine use in combination with chemotherapy in the pre-operative setting for patients diagnosed with stage II or III triple-negative breast cancer (TNBC). However, while these drugs have improved survival for some patients, they are associated with toxicities in approximately 45 percent of patients receiving this treatment. There is a critical need to better understand immune aspects of the tumor microenvironment as well as the immune cells circulating in a patient’s blood in order to identify factors that are associated with both response and toxicity to immunotherapy. Neo-TRIBUTE (Translational Resource for Immuno-Biology to Understand Therapeutic Efficacy) is a clinical trial designed to understand why immunotherapy works for some but not others, and to extend its use for a greater number of patients.
Dr. Mittendorf and her team have established a registry that will house biospecimens (tissue, blood and stool) from patients with TNBC who are going to be treated with immunotherapy (pembrolizumab) and chemotherapy. To date, the team has consented 30 patients who will allow use of their tissue from the time of diagnosis and then from surgery to perform studies that: 1) look at immune cells and markers present at the time of diagnosis that are associated with a good response to treatment or the development of toxicity, and 2) determine changes in the immune landscape between the initial biopsy specimen and surgical specimen after receiving immunotherapy and chemotherapy. Of the 30 patients consented, eight thus far have also agreed to have a biopsy approximately four weeks after starting treatment. This will allow Dr. Mittendorf to analyze whether there are early changes that are associated with response to treatment.
In the upcoming year, Dr. Mittendorf aims to complete accrual of at least 20 more patients for a total of 50.
Elizabeth Mittendorf, MD, PhD is the Robert and Karen Hale Distinguished Chair in Surgical Oncology and Associate Chair for Research in the Department of Surgery at Brigham and Women’s Hospital. She is also the Director of the Breast Immuno-Oncology program and Co-Director of the Breast Cancer Clinical Research Program at Dana-Farber/Brigham and Women’s Cancer Center. Dr. Mittendorf received her medical degree from Case Western Reserve University School of Medicine where she also completed a residency in General Surgery. She then served on active duty in the United States military before completing a fellowship in Surgical Oncology at the University of Texas MD Anderson Cancer Center. Dr. Mittendorf also holds a PhD in Immunology from the University of Texas Graduate School of Biomedical Sciences at Houston. She is board certified by the American Board of Surgery.
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