That’s what the genomic medicine team at the Avera Cancer Institute Center for Precision Oncology hopes to deliver, as they treat more breast cancer patients earlier in the course of their disease.
“One woman might have surgery for early stage breast cancer and remain cancer free. A second woman with a similar diagnosis might have a mastectomy, but then end up with another bout of cancer years later,” explained Casey Williams, PharmD, Director of the Avera Center for Precision Oncology. “On paper, the second woman has a very good chance of doing well without future cancer. But it still happens.”
Providing genomic sequencing that guides chemotherapy or other treatments before surgery is called neoadjuvant therapy.
When women are sequenced before surgery, the genomic team knows exactly what they’re dealing with, and whether or not a woman needs to have aggressive treatment up front to fight her particular type of cancer and prevent future recurrences.
Michele Reiman of Sioux Falls was such a case. In May 2015 she was diagnosed with stage I breast cancer, yet it was triple negative, a particularly aggressive type of breast cancer with a higher recurrence rate. Growth of triple negative cancer is not supported by hormones, so hormonal therapies are not effective against it. Her Avera medical oncologist, Amy Krie, MD, recommended that she have genomic sequencing.
“We wanted to make sure we were fighting it from every direction,” Michele said.
Michele had standard of care chemotherapy plus an oral medication as recommended by the genomic medicine team. At the time of surgery (a double mastectomy) Michelle was found to have had a pathologic complete response to the treatment with no detectable disease remaining. “After my surgery, I was 100 percent cancer free. I will never really know what killed the cancer; all I know is that it worked.”
The 10-year survival rate of breast cancer is higher than it’s ever been, at 83 percent. When caught in early stages, five-year survival is as high as 99 percent, according to the American Cancer Society.
“The vast majority of women live for many years after a breast cancer diagnosis, but those years may include treatment for relapses,” said Brian Leyland-Jones, MB BS, PhD, Vice President of the Avera Center for Precision Oncology.
“We want to do a better job of predicting the possibility of recurrence up front. Because if cancer comes back, it often comes back with a vengeance,” Leyland-Jones said.
Patients treated through the Avera Center for Precision Oncology receive standard of care protocols, plus care guided by sequencing. “We maintain the best conventional care, but at the same time we’re pushing the leading edge to improve outcomes,” Williams said.
Avera is seeing patients from Canada, California, Florida, New York, and as far away as the United Kingdom and Australia. “Patients are starting to understand what genomics has to offer, not just locally, but regionally and even internationally,” Leyland-Jones said.
If you are interested in genomic medicine, ask your oncologist about a referral to the Avera Cancer Institute Center for Precision Oncology or self-refer by calling 605-322-HOPE (605-322-4673).