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Eric P. Winer, MD
Professor, Medicine, Harvard Medical School
Director, Breast Oncology Center, Dana-Farber Cancer Institute
Physician Active Staff, Medicine, Brigham And Women's Hospital
Dana-Farber Cancer Institute
- Seeking to improve quality of life for patients with early-stage HER2 positive breast cancer.
- A clinical trial is planned to reduce post-surgery chemotherapy use in patients with excellent prognosis.
- This study will lay the groundwork for a large international trial aimed at reducing chemotherapy use in patients with good prognosis.
Early stage HER2-positive breast cancer is curable in most patients with standard therapies, which includes the use of chemotherapy. For many patients, however, chemotherapy adds toxicity without clinical benefit. Dr. Winer and his colleagues are conducting a clinical trial to challenge the “one-size-fits all” paradigm with the goal of reducing exposure to toxic drugs and improving quality of life for breast cancer patients.
Full Research Summary
More than 90 percent of patients with early stage HER2-positive breast cancer are cured with modern treatment regimens, but many receive treatment they don’t need. Overtreatment is a serious clinical concern and increases both medical costs and exposure to toxic treatments. Reducing the number of chemotherapy agents used will allow patients to maintain a better quality of life and decrease the chance of rare but serious chemotherapy complications.
Dr. Eric Winer and his clinical colleagues are conducting a clinical trial to test less intensive chemotherapy for carefully selected patients with HER2-positive breast cancer and an excellent prognosis. Patients with stage II and III HER2-positive breast cancer will be treated before surgery with paclitaxel (a chemotherapy) plus trastuzumab and pertuzumab (two HER2-targeted antibody therapies). Patients who have all cancer eradicated from the breast and lymph nodes by the time of surgery will go on to receive further HER2-targeted medicines after surgery, without any additional chemotherapy.
Under the current “one-size-fits-all” treatment strategy for HER2 positive breast cancer, all patients would receive two additional chemotherapy drugs after surgery, even though the benefit of more chemotherapy is uncertain. Among their goals of the study, Dr. Winer’s team will assess the willingness of patients and doctors to adhere to this novel treatment approach, and to gain an understanding of patients’ and doctors’ attitudes about including or omitting post-surgery chemotherapy.
The overarching goal of this small trial, which is a precursor to a large national/international trial investigating the same approach, is to help develop treatments for HER2-positive breast cancer that are highly effective but also minimize side effects for carefully selected patients.
Eric P. Winer, MD, is Professor of Medicine at Harvard Medical School and Chief, Division of Women's Cancers and the Thompson Senior Investigator in Breast Cancer Research at Dana-Farber Cancer Institute. He is also Co-Chair of the Breast Committee of the Alliance for Clinical Trials. Dr. Winer has devoted his professional career to the treatment of individuals with breast cancer and breast cancer research. He has designed and led phase I, II, and III clinical trials. Dr. Winer has collaborated closely throughout his career with psychosocial, health services, basic, and translational researchers. He is the Principal Investigator of the Dana-Farber/Harvard Cancer Center SPORE in Breast Cancer.
Dr. Winer is a graduate of Yale College, with a degree in History and Russian/East European Studies. He subsequently obtained his medical degree from Yale School of Medicine, followed by training in internal medicine at Yale. He completed a fellowship in medical oncology at Duke University Medical Center and remained on the Duke Faculty until 1997, when we moved to Dana-Farber Cancer Institute in Boston to assume the role of Director of the Breast Oncology Center.