[The following excerpts from Dr. Susan Love's blog are used with permission of the Dr. Susan Love Research Foundation.]

The American Association of Cancer Research (AACR) is the professional organization for scientists working on cancer. The annual meeting is large, international, and usually a bit overwhelming. The meeting is focused on all types of cancer. Sometimes the talks are quite basic about how cancer is initiated or how the immune system seems to work. Other talks are more clinical, usually with early data from phase one or two studies rather than from phase three studies (which are needed for drug approvals.) This is one of my favorite meetings on the annual calendar because it is the best place to get a glimpse into where things are going in cancer research and what the new breakthroughs are likely to be. This year was a good example.

It is well accepted that we all have mutations in our cells and acquire more mutations the older we are. One example mentioned was the bone marrow where the blood cells are formed. The blood stem cells divide once a month! Every time cells divide, they have the opportunity to make an error (like getting a "typo"), which is then propagated on to the next generation of cells, ad infinitum (or until you die.) Any one of these typos or combinations of typos could result in a cancer.

...Although the public usually thinks of the immune system as a barrier to cancer, the scientific community has not. Now that belief has changed as researchers have begun to explore how the immune system may be harnessed to prevent or control cancer. In order for a cancer to develop, it has to have a way of keeping the immune cells at bay by either turning off the immune cells or blocking them. If that is possible, it should be possible to turn the immune system back on. The trick, of course, is to program the immune system to attack just the cancer cells and NOT the normal ones. The early examples of this type of approach focus on prevention of recurrence, with examples such as the prostate drug ProvengeŽ, and two ongoing studies looking at preventing DCIS from becoming invasive by employing a HER2/neu vaccine.

A second approach is focused on using the immune system in the treatment of cancer. In order to grow and proliferate, tumor cells have to get past the immune system. They do this by keeping the T cells (a type of white blood cell that plays a central role in immune response) from multiplying or becoming active. A new approach that has had some early success is to block the cyclin-dependent kinases 4 and 6 (CDK4/6). In essence, this approach releases the "brakes" that the cancer cells put on the ever-vigilant T cells, allowing the T cells to go to town. The first drug, developed against melanoma, is ipilimumab and it, along with its cousin nivolumab, led to deep tumor regression in one-third of patients with stage IV melanoma.

In breast cancer, the big news was the results of the Paloma trial. This study compared CDK 4/6 with the drug letrozole (hormonal therapy) to letrozole alone in women with stage IV breast cancer that was ER-positive and HER2 negative. The combination of the hormone manipulation and the immune manipulation resulted in 80% of women with untreated metastatic disease having stable disease and an increase in relapse-free survival of 20 months. It is too soon to say whether there is an increase in survival overall....Read the complete blog post.

Learn more about Dr. Susan Love Research Foundation.  

[Editor's note: read about 2 additional PALOMA trials in article below!] 

[Editor's note: medical terms are linked to definitions in the National Cancer Institute's Drug Dictionary]

A very small percentage of adult patients participate in clinical trials. While there is a lot of speculation about why these numbers are low, no one really knows the answer. It could be because patients don't know about available trials, doctors are hesitant to refer their patients for trials, or are there simply no trials available for a specific patient group. Often that last part is the case for IBC patients. 

The Inflammatory Breast Cancer Research Foundation is a part of the National Breast Cancer Coalition Board of Directors. In partnership with NBCC, we're sharing the information below to help raise awareness of these trials to potential participants  None of the three trials lists IBC as an exclusion criteria so it appears IBC patients could participate if they meet the other criteria. Should you have interest, click on the links for more information on each trial. 

The National Breast Cancer Coalition (NBCC) is partnering with BioMarin and Pfizer on three upcoming clinical trials for women with metastatic breast cancer. Intervention offers the potential of improving the length and quality of life for patients already diagnosed with metastatic breast cancer. Trial accrual has begun for all three studies. 

NBCC advocates have been involved in many ways on these trials in the development of the protocols, as members of the Data Safety Monitoring Board, as reviewers of educational materials and consent forms and in conducting outreach activities to educate the public about the trials.

EMBRACA is a clinical trial for the PARP inhibitor BMN 673 (BioMarin) 

• This is a phase 3 study to evaluate safety & efficacy of BMN 673 in the metastatic setting. 
• Women with a BRCA 1 or BRCA 2 mutation and locally advanced or metastatic breast cancer are eligible. Additional eligibility criteria can be found at http://clinicaltrials.gov/ct2/show/NCT01945775.

PALOMA 2 is a clinical trial for the CDK 4/6 inhibitor Palbociclib (Pfizer) 

• This is a phase 3 study to evaluate safety & efficacy of Palbociclib with letrozole in the metastatic setting. 
• First-line treatment for those with ER+ (hormone receptor positive) and HER2- (HER2 negative) locally advanced or metastatic breast cancer.  Additional eligibility criteria can be found at http://clinicaltrials.gov/ct2/show/NCT01740427 .

PALOMA 3 is a clinical trial for CDK 4/6 inhibitor Palbociclib (Pfizer) 

• This is a phase 3 study to evaluate the efficacy & safety of Palbociclib with fulvestrant in the metastatic setting. 
• Patients with ER+ (hormone receptor positive) and HER2- (HER2 negative) locally advanced or metastatic breast cancer who have progressed on or after prior endocrine therapy.  Additional criteria can be found at http://clinicaltrials.gov/ct2/show/NCT01942135 . 

Please note that each of these trials are designed for a very specific population of patients. In this era of more personalized treatment it is important that patients for the trials have the identified targets for the trial therapy. It can be challenging to find an adequate number of patients who meet these very specific criteria so it's important that patients be aware of these opportunities so better treatment options can be made available to the general patient population outside of trials.

Author: Bob Riter; ISBN: 0897936795

From a review by Alysa Cummings:

"Bob is the executive director of the Cancer Resource Center of the Finger Lakes in Ithaca, NY where every day of the week he helps patients navigate the journey from diagnosis through cancer treatment to a place of healing and recovery. In addition, Bob himself is a breast cancer survivor. He's "been there and done that;" so when it comes to the physical and emotional challenges of surgery and chemotherapy, Bob writes about what he knows firsthand. Either life experience would make Bob superbly qualified to write a book with the title When Your Life is Touched by Cancer: Practical Advice and Insights for Patients, Professionals, and Those Who Care. But paired together, his expertise and credibility shine brightly indeed."

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