June 7, 2012

VICC patient lauded for clinical trial participation

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Cancer patient Jeanette Daniel, left, talks with Ingrid Mayer, M.D., MSCI, during a recent clinic visit. Daniel has taken part in two clinical research trials at Vanderbilt-Ingram Cancer Center. (photo by Joe Howell)

VICC patient lauded for clinical trial participation

A breast cancer patient who has enrolled in two clinical research trials at Vanderbilt-Ingram Cancer Center was the only presenter to receive a standing ovation during a recent Stand Up To Cancer (SU2C) news briefing at the American Association for Cancer Research (AACR) annual meeting in Chicago.

Jeanette Daniel, 51, a metastatic breast cancer patient, is taking part in clinical trials funded by SU2C which has put together Dream Teams of leading cancer researchers who focus on specific challenges in cancer. VICC’s Carlos Arteaga, M.D., associate director for Clinical Research and director of the Breast Cancer Program, and Ingrid Mayer, M.D., MSCI, clinical director of the Breast Cancer Program, are members of the Dream Team studying the role of PI3-kinases in women’s cancers.

Daniel was first diagnosed with stage 3a breast cancer in 2006. The former Memphis zookeeper underwent intensive treatment in Memphis, but two years later the cancer recurred.

For the next three years, she endured round after round of chemotherapy.
“No matter what we threw at it, it just grew and grew and grew,” said Daniel.

Daniel’s partner, who is a physician, finally went online and found a clinical research trial at VICC for estrogen receptor-positive metastatic breast cancer patients. Daniel traveled to Nashville and met with Mayer.

“She told me not only was she a researcher but she was a doctor and she would always take care of me as a patient first. We left that place giddy,” remembered Daniel.

Mayer is the national principal investigator for a Phase 1b trial combining letrozole (an aromatase inhibitor, which is an anti-estrogen medication) and a drug called BKM120, a PI3K inhibitor.

“For the first time, these two drugs were combined. The main point was to find out if this was safe, tolerable and had some preliminary activity,” explained Mayer.

Over the next few months, scans showed Daniel’s tumors fading until they were no longer visible on the PET scans. She also started feeling better.
Mayer said the drug combination has shown clinical activity.

“Jeanette is one of the patients who had a PIK3CA mutation in her tumor and she was the patient who stayed the longest in the trial; almost a whole year. It worked pretty well for her but we don’t know yet if patients with the mutation are the ones who benefit the most. We can’t conclude that yet,” said Mayer.

While Daniel’s results do not prove that the drug combination will be more successful in tumors with a PIK3CA mutation, her response was encouraging enough to spark the attention of SU2C researchers and supporters, resulting in a last-minute surprise invitation to speak in Chicago.

“They came and picked us up in a big limousine with leather seats and the whole thing,” said Daniel.

More limousine rides and a room in a Chicago lakefront hotel left Daniel feeling special.

But the highlight of the trip was the chance to thank the people who are supporting and conducting cancer research.

“These are my heroes. These are the people who have kept me going. These are the people who every day are in the trenches working and working. To have them thank me was embarrassing. These are the people who are really changing the world,” said Daniel.

Eventually, the first drug combination stopped working so Daniel is now enrolled in a clinical trial testing a combination of a PI3K inhibitor drug called XL147 and a monoclonal antibody against HER3. The study is led by VICC’s Vandana Abramson, M.D.

“The idea is to make the PI3K inhibition more potent by adding the HER3 antibody,” explained Mayer.

Daniel knows she may not be cured by the new therapies but she wants to take part in clinical studies to help others.

“I came here because I have nieces and they have children and I figured if I had to go through this, there might as well be some purpose….and the whole experience has been so uplifting.”