Cancer Stem Cells May Facilitate Recurrent and Metastatic Breast Cancer

Jenny C. Chang, M.D. Director, Houston Methodist Cancer Center Professor of Medicine, Weill Cornell Medical College Full Member, Houston Methodist Research Institute Houston, Texas

Dr. Jenny C. Chang

MedicalResearch.com Interview with:
Jenny C. Chang, M.D.
Director, Houston Methodist Cancer Center
Professor of Medicine, Weill Cornell Medical College
Full Member, Houston Methodist Research Institute
Houston, Texas 

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Chang: The current treatment of triple negative breast cancer, which accounts for about 15% of all cases of breast cancer, is still based on surgery, radiotherapy, and classic chemotherapy because, unlike other types of breast cancer, it is not amenable to hormonal or targeted therapy. However, research findings suggest that cancer stem cells, which represent about 2% of all neoplastic cells, may play a role in disease relapses and the formation of distant metastases. As these cells may represent a therapeutic target, the aim of this study is to modify the micro-environment in which they reproduce by acting directly on the chemokines involved in inflammation because there is evidence indicating a possible mechanism of action of reparixin, a molecule developed by Dompé, an Italian biopharmaceutical company, in the targeted treatment of these cancers.


MedicalResearch: What should clinicians and patients take away from your report?

Dr. Chang: Experimental and clinical findings demonstrate that cancer stem cells favour the recurrence of treated tumours and facilitate the onset of metastases. The aim of the study is to compare the effect of a combination of reparixin and classic chemotherapy on disease progression and the development of new metastases with that of chemotherapy alone. A recently completed Phase Ib study in patients with metastatic breast cancer has shown that the combination of reparixin and paclitaxel (a widely used chemotherapeutic agent) was associated with a low incidence of non severe adverse reactions, and led to a sizeable response rate and time to progression. The results of the multicenter, randomized, double-blind “fRida” trial will show the extent to which reparixin-induced control of cancer stem cells can affect disease progression. The Phase 2 trial is currently under way in 65 centers in 7 countries.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Chang: Metastatic triple negative breast cancer is a therapeutic challenge for medical oncologists because the only therapeutic option other than radiotherapy and surgery is chemotherapy which, however fundamental it may be in the treatment process, actually seems not to eliminate cancer stem cells and, consequently, may lead to disease progression and the development of distant metastases. The working hypothesis that the fRida trial aims to verify is that reparixin can extend the progression-free survival of patients over that afforded by chemotherapy alone by targeting cancer stem cells. The final objective is to develop a targeted therapy that can satisfy the still unmet medical need for triple negative breast cancer.

Citation:

SABCS 2015 Abstract

A randomized, placebo-controlled phase 2 study of paclitaxel in combination with reparixin compared to paclitaxel alone as front-line therapy for triple-negative breast cancer (fRida)

Jenny C. Chang, M.D. (2015). Cancer Stem Cells May Facilitate Recurrent and Metastatic Breast Cancer