There are currently at least six different types of chemotherapy that can be used as a possible therapy for patients, and each one may affect each individual patient in a different way. To tailor the treatment to each distinct patient, the Markey investigators aim to test the tumors in a set of animal model “avatars” with these different therapies to gauge the response.
Here’s how the proposed trial would work: After the patient’s biopsy, her cancerous tissue would be transferred into a mouse that is bred to grow human tumors, then subsequently into three dozen mice: her “avatars.” While the patient undergoes neoadjuvant chemotherapy and then surgery – a process that can take up to six months – the avatars will be divided into groups, with each group receiving one of the six available chemotherapies.
When the researchers see which avatar group has the best result, they’ll know which chemotherapy should work best for that patient. Knowing this would provide additional options for women who have residual cancer after neoadjuvant chemotherapy and may reduce their risk for disease recurrence.
“It would prevent us from having to experiment with each individual patient, and end up finding that they didn’t respond to that therapy,” said Kathleen O’Connor, PhD, director of Markey’s Breast Translational Group. “If we can do this, then the oncologists will no longer have to guess.”
Aju Mathew, MD, MPhil, a medical oncologist who treats triple-negative breast cancer patients at Markey, compares his team’s game-changing proposition to the way Uber has disrupted the use of public and personal transportation.
“This trial is our way of disrupting the current standard of care, the current technology and the current practice of medicine, to try to change the paradigm of a ‘one size fits all’ approach for triple-negative breast cancer patients,” Mathew said.
Although the avatar model of research isn’t new, O’Connor notes that not many researchers are using them specifically for the treatment of an individual patient. Using a trial protocol to get the tissues directly from the patient’s biopsy is a key factor in making the research work.
With the trial design in place, the team just needs to provide ample data showing that growing a patient’s tumor in the avatar from biopsy will work.
Initial pilot funds stemming from Markey’s National Cancer Institute (NCI) designation grant have enabled the team to establish its first set of avatars with tissues taken from patients’ surgeries. But a boost in support would help them establish the preliminary data for the trial and allow the team to then apply for major federal funding.