According to a researcher at Thomas Jefferson University’s Kimmel Cancer Center in Philadelphia, a drug currently used to treat a certain lymphoma has demonstrated positive effects in a preclinical study of inflammatory breast cancer (IBC). This positive result has led to a Phase 1/2 clinical trial at Kimmel Cancer Center to test Romidepsin (Istodax) in combination with nab-paclitaxel (Abraxane) chemotherapy for advanced IBC.
Massimo Cristofanilli, M.D., F.A.C.P., Professor of Medical Oncology and Director of the Jefferson Breast Care Center and senior investigator, notes, “Because this kind of breast cancer is very difficult to treat, we hope this new combination of anticancer agents will change the outcome of this aggressive disease,”
The current study was an effort in collaboration with the lead author, Fredika Robertson, Ph.D., at The University of Texas MD Anderson Cancer Center. The research was funded by a Promise Grant from the Susan G Komen Foundation awarded to Drs. Cristofanilli and Robertson in 2008.
Cristofanilli adds, IBC is the most metastatic variant of locally advanced breast cancer. Even though IBC accounts for only 2 to 5 percent of all breast cancers in the U.S. (13 percent globally), it is responsible for a greater number of deaths from breast cancers. Cristofanilli goes on to say, that one reason that it is so deadly is that emboli form early in cancer development. These emboli spread through the lymphatic system causing breast swelling. These emboli or aggregates of cancer cells are highly resistant to chemotherapy and radiation. They are believed to be responsible for rapid spread of the disease.
Cell culture experiments and mice models have demonstrated that Romidepsin is able to break chemical bonds between cancer cells that hold them together. By separating the cancer cells, chemotherapy becomes effective. Romidepsin is a histone deacetylase (HDAC) inhibitor. This is a new group of drugs that have the ability to regulate gene transcription. The current study tested two other HDAC inhibitors and compared them to Romidepsin and found that Romidepsin gave the best results.
Romidepsin was approved to treat cutaneous T-cell lymphoma back in 2009. Currently its is under further investigation in clinical trials for use in other lymphomas. Cristofanilli comments, “This study is a nice example of a transition from the laboratory to the clinic. Our laboratory work suggested it might be helpful to treat inflammatory breast cancer, and now we are about to open a clinical trial to test that very promising possibility.”