Incorporating Collaboration and Personalization of Treatment in Breast Cancer Care

The ever-evolving field of breast oncology is continuously changing, and is important to adapt to the needs of the patients, according to Tiffany A. Traina, MD, and Sherry Shen, MD.

Both oncologists focused on the inclusion of multidisciplinary care, the personalization of treatments, and clinical trial diversity. Traina, vice chair of Outpatient Operations in the Department of Medicine, and section head of the Triple Negative Breast Cancer Clinical Research Program at Memorial Sloan Kettering Cancer Center (MSKCC), and Shen, an assistant attending physician at MSKCC, both discussed these issues during a Breaking Barriers: Women in Oncology segment.

Traina:

It’s evolved in many ways. In one way, the collaborations are incredibly tight with the observations that are being made by our basic scientists. Communication is much better and having translational scientists in the room to say how a preclinical observation can be impactful for our patients [has been helpful]. Those partnerships across academia and with our pharmaceutical colleagues have fast-tracked the science to be impactful for our patients. Better multidisciplinary collaborations [have occurred]. Another way it’s changed is the whole acknowledgment of how biomarkers are relevant. The old way we did science was there was a new drug of interest, we didn’t have refinement, about which patient population we necessarily tested that drug in. Now biomarkers are helping us to identify who is most likely to benefit from a drug. We can design smarter studies as a result.

Shen:

That’s the exciting thing about our field is how we personalize our treatments going forward. There’s so much work being done in this area. Historically, there was the age of escalation. Perhaps we’re in the age of de-escalation, we’re refining more appropriately using both clinical pathologic, but also now genomic characteristics and how we offer treatment regimens to patients. What’s exciting to me about what’s evolving is, eventually, we’ll be able to say, we’ve done all this information gathering or data gathering about your case. Because of X, Y, and Z characteristics, this is the exact regimen that I would recommend. That’s exciting to both use that to balance toxicities and efficacy, and pioneer these new treatments in our field.

Traina:

The other thing that has evolved and is so critically important is that our trials are specifically trying to represent the diversity of the patients that we care for. That is a priority. Beyond just an initiative, it is recognizing that we have a very diverse population of patients that we care for. Historically, our clinical trials did not recruit ethnic diversity, older patients, and even diversity by gender. There was a lack of being able to necessarily extrapolate the results that we saw from some of those early studies to the patients that we were treating in the clinic. That is now a real priority as we’re designing trials, getting them out there dispelling myths about clinical trial participation, and being sure we get those drugs and those opportunities to diverse populations on the study.