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Neelima Vidula, MD
Massachusetts General Hospital
Conquer Cancer, the ASCO Foundation
Goal: Identifying metastatic breast cancer patients that may benefit from PARP inhibitor treatment.
Impact: Currently, two PARP inhibitors, olaparib and talazoparib, are being used to treat MBC patients with inherited mutations in the BRCA genes. Since inherited BRCA1 or BRCA2 mutations only accounts for 5-10 percent of breast cancer, Dr. Vidula hypothesizes that detecting tumor BRCA mutations may identify a novel population of patients who may benefit from PARP inhibitor treatment. Therefore, she is determining the utility of a liquid biopsy to detect tumor BRCA mutations in patients with MBC.
What’s next: She and her team will continue to assess the utility of this novel technique -liquid biopsy - to identify MBC patients with tumor BRCA mutations who may benefit from matched therapy with talazoparib.
Metastatic breast cancer (MBC) accounts for virtually all breast cancer deaths and it is critical to develop better treatment strategies. PARP inhibitors have been shown to result in better treatment outcomes for patients with inherited BRCA1 and BRCA2 mutations compared to chemotherapy. Inherited mutations in the BRCA genes occur in a small percentage of breast cancers and Dr. Vidula is determining if patients with tumors that harbor BRCA1 and BRCA2 mutations can be detected by liquid biopsy to identify a subset of MBC patients that may respond to PARP inhibitor treatment.
Full Research Summary
Research Area: Investigating the utility of liquid biopsy to identify metastatic breast cancer patients that may benefit from PARP inhibitor treatment.
Impact: Since metastatic breast cancer (MBC), or stage IV breast cancer, accounts for most breast cancer deaths, there is an urgent need to develop more effective treatment strategies. Since studies have demonstrated that PARP inhibitor treatment results in better progression‐free survival (PFS, the amount of time a tumor does not grow on treatment) compared to chemotherapy, two PARP inhibitors, olaparib and talazoparib, are currently being used to treat MBC patients with germline (inherited) BRCA1 or 2 mutations. However, inherited BRCA mutations only account for 5‐10 percent of breast cancer, limiting the usefulness of PARP inhibitors. A critical question is whether PARP inhibitors may also be beneficial in MBC with tumor BRCA mutations, as is the case for tumor BRCA mutant ovarian cancer where they are effective. Liquid biopsies analyzing circulating cell‐free DNA (cfDNA) have the potential to unveil tumor mutations as indicated by Dr. Vidula’s previous studies. Therefore, she hypothesizes that a liquid biopsy can be used to detect tumor BRCA mutations in patients with MBC and help to identify a novel population of patients who may benefit from PARP inhibitor treatment.
Current research: As part of her Conquer Cancer study, supported by BCRF, Dr. Vidula is evaluating the efficacy (defined by PFS status at 12 weeks) of talazoparib in patients with tumor BRCA mutant MBC as detected by liquid biopsy. In preliminary studies, Dr. Vidula and her team collected samples for liquid biopsy and analyzed these samples for tumor BRCA mutations. This analysis revealed that 13.5 percent of patients with MBC have tumor BRCA mutations, largely in the absence of inherited BRCA mutations. She and her team will continue to assess the utility of this novel technique -liquid biopsy - to identify MBC patients with tumor BRCA mutations who may benefit from matched therapy with talazoparib and determine the efficacy of the drug in these tumor mutant patients.
Neelima Vidula, MD is a breast medical oncologist at Massachusetts General Hospital (MGH). She completed medical school and residency in internal medicine at Northwestern University and a clinical and research fellowship in hematology and medical oncology at the University of California, San Francisco. Dr. Vidula is the principal investigator of many early phase clinical trials studying novel agents for patients with breast cancer. Among these trials, she is the national co‐principal investigator of a multi‐center study using immunotherapy and chemotherapy for chest wall disease, through the Translational Breast Cancer Research Consortium. Dr. Vidula also conducts clinical research evaluating the impact of biomarkers on therapy response and patient outcomes as well as research in precision medicine using cell‐free DNA and tumor genotyping. She strives to provide outstanding patient care and incorporate the latest data and newest therapies in treatment plans for patients.