Pathway Changes in Breast Cancer

Hope S. Rugo, MD, from the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discusses pathway changes in breast cancer.

Hope S. Rugo, MD, professor of medicine and director of breast oncology and clinical trials education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discusses pathway changes in breast cancer.

There are a number of trials looking at mutations in the PI3K pathways to determine whiter patients have a mutation in those pathways are more likely to benefit from PI3K inhibitors. The real need, Rugo says, is in exploring pathway changes: mutations in multiple parts of the same pathway. Trials in this space include neoadjuvant studies as well as adjuvant studies that have a longer time to endpoint.

Clinical Pearls

Rugo says that the I-SPY trial embodies this concept: A novel agent is compared with standard treatment and serial biopsies allow researchers to analyze general pathways changes to identify which tumors will benefit from a specific treatment. This method could direct the oncology community to smaller trials in the future that are directed to the right tumor biology.

  • There are a number of ongoing trials analyzing the PI3K pathways in patients with breast cancer
  • In a trial like I-SPY, serial biopsies allow researchers to analyze general pathway changes to identify which tumors will benefit from a specific treatment