New breast cancer treatment may help wipe out cancer before surgery

A new breast cancer treatment is showing promising results for wiping out cancer before surgery.

“I love my job,” says 47-year-old firefighter Piper Denlinger, “I am so lucky. I have the best job, in the best fire department, in the United States."

But a few months ago, Denlinger was diagnosed with stage-two breast cancer.

"The real emotional hard part was the next day,” says Denlinger, “Getting up before everybody and realizing that was going to be the last time I was going to get to drive that engine for a long time."

Denlinger was soon put in a clinical trial called I-SPY at University of California-San Diego Health System.

The trial uses chemo-therapy along with biological agents to target, and wipe out cancer before surgery.

However, the I-SPY trial is only for patients with inch-sized tumors.

"It's not so much killing cells as changing them,” says Anne Marie Wallace, a doctor, breast cancer surgeon, and professor of surgery at Moores University of California-San Diego Cancer Center, “So they then can't go on to duplicate and become worse, and worse, and worse."

Doctors use MRI's and biopsies to constantly monitor tumors and see how medication is working, using the information to adjust it when necessary.

Most clinical trials take 10 to 15 years to determine if drugs are working, but I-SPY's feedback is immediate.

"What you do is shrink the tumor enough that 65 percent of the time, when you thought you were going to have to remove the breast, you can actually just do a lumpectomy," says Marie Wallace.

After only three weeks into Denlinger’s treatment, her tumor has already become smaller.

"The fact that this little pill that I take every day is designed specifically for what I've got. That's amazing,” says Denlinger.

Although she still suffers nausea and exhaustion, Denlinger was feeling well enough to make her first trip back to the firehouse since her diagnosis only a day after another breast cancer milestone, shaving her head.

"It's just another stage,” says Denlinger, “Every stage I go through means I’m one stage closer to getting back to work or it gets me back whole. I miss my crew. I miss coming to work. I miss these clowns."

Denlinger hopes to be back to work full-time by September.

Research Summary:


BACKGROUND: The main goal of the I-SPY clinical trial is to speed up treatment for breast cancer. The information learned in the I-SPY trial will help physicians provide a better prognosis for breast cancer patients and help them select more effective treatments. Researchers also hope to reduce the cost and time it takes to get promising new drugs to the market. I-SPY is a multi-center clinical trial, which is designed to evaluate the impact of chemotherapy before advanced patients undergo surgery.

I-SPY 1 TRIAL: The I-SPY 1 trial started in 2003. The goal was to see if researchers could predict how a patient would respond to neoadjuvant chemotherapy (chemotherapy given to reduce tumor size, before surgery) using multiple MRI scans and biomarkers (characteristics of a cell that provide information about how the cell is behaving). Researchers didn't use any investigational drugs in I-SPY 1. Instead, the trial involved serial imaging and tissue collection from women with tumors at least three centimeters in size.

I-SPY 1 FINDINGS: Researchers found that most locally advanced breast cancers are discovered in between routine mammogram exams, which usually happen every one or two years. Therefore, investigators say women should not ignore a growing breast mass, even if there is a recent normal mammogram. Researchers also found the response to therapy and outcome can be predicted by many biomarkers.

I-SPY 2 TRIAL: The second phase of the trial, I-SPY 2, was launched in March of 2010. The goal of I-SPY 2 is to take what researchers learned in I-SPY 1 and test which investigational drugs benefit patients. I-SPY 2 has the potential to reduce the costs of drug development and speed up the process of getting promising drugs to the market. The trial will screen multiple cancer drugs from multiple companies. Researchers will use the drugs and standard neoadjuvant chemotherapy to learn which new drug agents are most beneficial for women with certain tumor characteristics. They also hope to eliminate ineffective treatments more quickly. Researchers hope to test more than 800 patients over a four-year period. I-SPY 2 is still enrolling women with newly diagnosed invasive breast cancer. To find out more about how to participate visit,

Jackie Carr, Media Relations
University of California, San Diego
San Diego, CA

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