Nadine M. Tung, MD

• Seeking biomarkers to guide treatment decisions in triple negative and BRCA-driven breast cancers.

• A clinical trial is ongoing to compare a platinum-based therapy to standard chemotherapy in patients with a mutation in the BRCA gene. 

• This trial will help to determine which patients are most likely to benefit from a common drug called cisplatin and advance effective therapies in these aggressive breast cancers.

Triple negative breast cancer (TNBC) comprises approximately 15 percent of all breast cancer and is the most common cancer caused by mutations in the BRCA genes. The clinical management of TNBC and other BRCA-related breast cancers is challenging due the often-aggressive behavior and lack of targeted therapies.

Cisplatin causes a type of DNA damage that cannot be repaired by cells that are defective in DNA repair, leading to tumor cell death. Many TNBCs and all BRCA -drive breast cancers share this defect, making cisplatin, a DNA damaging agent, a promising therapy for these cancers. While not typically used to treat breast cancer, cisplatin has demonstrated good activity in clinical trials of BRCA mutation carriers with breast cancer.

The INFORM trial (NCT01670500) is a randomized clinical trial designed to compare the relative effectiveness of cisplatin and standard chemotherapy in women with early-stage breast cancer who have inherited BRCA mutations. The trial is being conducted at Dana-Farber Harvard Cancer Center, as well as eight sites outside of Boston, including three through the Translational Breast Cancer Research Consortium (TBCRC).

The investigators are in the process of collecting research biopsies and blood samples that will be used to determine which patients respond better to each therapy. Eighty-nine patients out of a target accrual of 170 are enrolled, and the research team anticipates accrual to be completed within three years.