Taking on inflammatory breast cancer

This year alone, the National Cancer Institute (NCI) predicts that over 1.6 million new cases of cancer will be diagnosed in the U.S. with more than 595,000 who will die from this disease. According to the American Cancer Society, it’s estimated that breast cancer alone will total up to 246,660 new cases for women this year.

There is certainly an immense awareness for breast cancer beyond the month of October, the conversation becomes a focal point at this time of the year, giving us an opportunity to discuss advancements.

{mosads}While the general public recognizes breast cancer as a single disease, many don’t realize that there are more than ten different types of breast cancer diagnoses, including non-invasive, invasive, recurrent, and metastatic breast cancers. A form of the disease that often goes unheard of is inflammatory breast cancer, or IBC.

Typically diagnosed at either stage III or IV, IBC is a rare and rapidly-progressing form of breast cancer with limited research, education and treatment options. Further, IBC, sadly, is also the deadliest form of the disease.

IBC accounts for one to five percent of all breast cancers diagnosed in the U.S. Its symptoms differ from those of more common breast cancers and can therefore be harder to diagnose, as lumps are not typically felt during physical exams or found through mammogram screenings, which is why it usually goes unnoticed until at least stage III.

At that point for some, approximately 30-35 percent of it has already spread to distant lymph nodes or organs and it is diagnosed as stage IV. According to the NCI, most IBC are invasive ductal carcinomas that are developed from the cells that line the milk ducts of the breast, which then spread beyond the ducts.

My first personal encounter with this disease was in the late 1990s when we entered breast cancer patients into our clinical trials with the nation’s first protein bound nanoparticle chemotherapy.

At a lower dose of drug we were surprised by the rapid response to weekly low doses of the drug even in patients with inflammatory breast cancer. The first clue, even then, was that the tumor microenvironment and the body’s immune system played an important role in combatting cancer.

The current standard, or status quo, of treatment for IBC — and nearly all other cancers — is generally first with chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy.

All of which come with painful and sometimes debilitating side effects — including the most harmful side effect of all — denigration of the immune system.

An intact immune system is desperately needed to fight off the disease.  To change the paradigm in how we treat patients with cancer, Cancer MoonShot 2020, a global cancer collaborative, officially launched January this year, was established to educate and engage with oncologists, patients and payers about orchestrating an array of novel approaches to activate the patient’s immune system.

It is my firm belief, forged over 25 years of pursuing regenerative and immunotherapy science that only by carefully orchestrating the complex immune system through combining Natural Killer cells, B cells, dendritic cells with immuno-stimulants can we win the war against cancer.

This unprecedented alliance of Cancer MoonShot 2020 comprises of large pharma, biotech, major payers, fortune 50 companies, academia and community oncologists to accelerate this combination immunotherapy approach as the next generation standard of care in patients with cancer. The singular mission of the group is to identify personalized patient treatments to win the war against cancer by 2020.

To date our program is involved in over 20 single agent immune-based therapy Phase 1 and 2 trials in progress. We are exploring patients with cancer at all stages of disease in up to 20 tumor types and in as many as 20,000 patients by the year 2020.

Patients will be enrolled in the QUILT program (Quantum Integrative Lifelong Trial), which will test novel combinations of vaccines, cell-based immunotherapy, metronomic chemotherapy, low dose radiotherapy and immunomodulators, including check point inhibitors, with the goal of achieving durable, long-lasting remission for patients with cancer. The goals and mission of this novel trial has been described in Nature and the Journal of the American Medical Association (JAMA.) 

A major component in identifying treatment strategies for patients lies within GPS Cancer tests. Developed by NantHealth, GPS Cancer is a unique, comprehensive molecular profile of a patient’s cancer that informs oncologists of personalized treatment strategies and identifies therapies that may have clinical benefit for the patient, including the QUILT program.

In combination with these major milestones evolving under the Cancer MoonShot 2020 program, leading oncologists from a variety of renowned institutions have come forth to establish assorted Working Groups for different cancer types. A previous article in The Hill titled “Collaboration, not just money, is what’s needed to fight cancer” certainly rings true to the goals of the Cancer MoonShot 2020 program.

Members are bringing their collective wisdom and expertise together creating an unprecedented power to advance the way we treat cancer. To date, we’ve established six Working Groups — including Global Inflammatory Breast Cancer and Breast Cancer.

Our IBC Working Group advocate, Valerie Fraser, who is a patient, survivor, and board member of the Inflammatory Breast Cancer International Consortium (IBC-IC) and diagnosed in 2007 with stage III IBC states: 

“Because there is such limited research, knowledge and education about IBC, patients must face many barriers throughout their diagnosis and treatment.  Unfortunately, because IBC spreads and metastasizes so rapidly, we just don’t have any time to spare. The Cancer MoonShot 2020 IBC Working Group will offer each IBC patient an innovative, GPS Cancer-informed immunotherapeutic approach exploring the precise biology driving their unique cancer, resulting in better overall treatment outcomes so patients with IBC will finally have a strategic roadmap to successfully conquer this cancer.”

We’re excited to work together in this monumental movement to win the war against both common and rare cancers like inflammatory breast cancer. The potential of immunotherapy is massive and with all of the brilliance involved in the Cancer MoonShot 2020 program, we’re looking forward to continuing to work toward our goals at the pace we are making life changing discoveries along the way. 

Soon-Shiong is a physician, surgeon and scientist who has pioneered novel therapies for both diabetes and cancer, published over 100 scientific papers, and has over 170 issued patents worldwide on groundbreaking advancements spanning myriad fields of technology and medicine. His pioneering work on the Cancer Moonshot 2020 initiative has recently been featured in Nature and the Journal of the American Medical Association (JAMA.) Read more about Dr. Soon-Shiong and his decades-long quest to change the current paradigm of cancer care.

The views expressed by contributors are their own and not the views of The Hill.