Associate Professor of Oncology
Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins University School of Medicine
Seeking to advance the use of immunotherapy in breast cancer with combination approaches that enhance the patient’s immune response.
Laboratory studies are ongoing to test an immunotherapy combination in a model of HER2-positive breast cancer.
These studies may lead to clinical trials of potent immunotherapy combinations for patients with recurrent HER2-positive breast cancer.
Cancer immunotherapy is a new treatment approach that enlists the patient's own immune system to fight cancer. Monoclonal antibodies that block the PD-1 immune checkpoint (called checkpoint inhibitors) unleash a robust anti-tumor immunity and yield tumor responses in a broad range of tumors.
Although some breast cancer patients respond to PD-1 blockade, the majority do not respond. Moreover, most of the trials testing PD-1/PD-L1 modulators in breast cancer have been in the triple negative breast cancer subtype. As yet, there has been little efficacy reported of checkpoint inhibitors for HER2-positive breast cancer. This may be due to a lack of specialized immune cells (called T cells) at the tumor sites. Strategies that induce T cells and counter the tumor’s immunosuppressive properties will be required for immunotherapy to work in most breast cancer patients.
Drs. Emens and Jaffee showed that adding PD-1 pathway blockade plus an additional immune-based treatment significantly enhances immune cell activity and increases tumor-free survival in laboratory models. In the coming year, the team will test this strategy to HER2+ breast cancer by combining the HER2-targeting drug trastuzumab with the immunotherapy regimen to induce adaptive immunity and support tumor-specific T cells.
They hope to develop a highly active immunotherapy regimen that will translate into a clinical trial testing the most potent combination immunotherapy regimen in patients with recurrent HER2+ breast cancer.
Leisha Emens is an Associate Professor of Oncology at the Sidney Kimmel Comprehensive Cancer Center. She received her MD-PhD from Baylor College of Medicine and completed her residency training in Internal Medicine at the University of Texas at Southwestern before coming to Johns Hopkins in 1998 for a fellowship in Medical Oncology and Hematology. Dr. Emens specializes in cancer immunotherapy, and her research focuses on the development and implementation of breast cancer immunotherapies (including vaccination strategies and immune checkpoint blockade) in combination with traditional anticancer therapies and newer biologically targeted therapies. She is a member of the FDA Advisory Committee on Cell, Tissue, and Gene Therapies, and on the editorial boards of the Journal of Clinical Oncology, Cancer Research, and the Journal for the Immunotherapy of Cancer.