Episode 82: Rewriting the Story of Triple-Negative Breast Cancer with Dr. Sara Tolaney
In this enlightening episode of the Patient From Hell, host Samira Daswani interviews Dr. Sara Tolaney, a leading oncologist specializing in breast cancer. They delve into the evolving landscape of triple-negative breast cancer (TNBC), exploring advancements in treatment, from targeted therapies to immunotherapy, and the challenges faced by patients in both early-stage and metastatic settings. With her characteristic warmth and expertise, Dr. Tolaney provides actionable insights for patients and caregivers, offering hope and understanding in navigating this complex diagnosis.
Key Highlights:
- A New Paradigm in Early-Stage TNBC Treatment: Dr. Tolaney explains how neoadjuvant chemotherapy combined with immunotherapy has revolutionized outcomes, achieving pathologic complete response rates above 60%.
- Metastatic TNBC Advances: The discussion highlights the critical role of biomarker testing and the introduction of innovative therapies like antibody-drug conjugates, providing extended survival for many patients.
- Empowering Patient Symptom Management: The episode underscores the importance of patient-reported outcomes and emerging tools like health apps to enhance self-management and real-time support for side effects.
About our guest:
Sara Tolaney, MD, MPH is the Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, and is internationally recognized for her research and education leadership in breast cancer. She also serves as Associate Director of the Susan F. Smith Center for Women’s Cancers and is a Senior Physician at Dana-Farber Cancer Institute and Associate Professor of Medicine at Harvard Medical School.
Dr. Tolaney received her undergraduate degree from Princeton University and her medical degree from UC San Francisco. She subsequently completed her residency in Internal Medicine at Johns Hopkins University, and fellowships in hematology and medical oncology at Dana-Farber Cancer Institute. She obtained her Masters in Public Health from Harvard School of Public Health.
Her research focuses on the development of novel therapies in the treatment of breast cancer and developing more effective and less toxic treatment approaches. Her work has demonstrated that a relatively low risk regimen is beneficial in women with early stage node-negative HER2-positive cancers, and this works has been incorporated into national and international guidelines. She has developed several follow-up studies looking at novel approaches to early stage HER2-positive disease and has also played a significant role in development of cdk 4/6 inhibitors, antibody drug conjugates, and immunotherapy in breast cancer. She currently chairs several registration studies in these areas and also leads many investigator-initiated trials. She is the author of over 150 peer-reviewed publications with manuscripts included in many prestigious journals such as the New England Journal, Lancet Oncology, Journal of Clinical Oncology, and JAMA Oncology.
Key Moments:
At 8 minutes: "It used to be that if someone had a triple negative breast cancer, we would often take someone to surgery and then after surgery give them some chemotherapy to kill any stray cells that might've gotten into the bloodstream and integrate radiation as needed. But we've really changed our approach very dramatically over the last few years where we've learned that if someone has an early stage, stage two or three triple negative breast cancer, it is actually very critical that they not go to upfront surgery, but in fact get chemotherapy with immunotherapy prior to surgery."
At 22 minutes: "When compared head to head to chemo, [Trodelvy] not just improved how long someone's cancer was controlled, but in fact, you know, more than doubled survival in triple negative disease when compared to standard chemo. And then the other antibody drug conjugate (ADC) was the one we alluded to earlier, trastuzumab deruxtecan, which works in patients who have some level of HER2 expression in the tumor, where it also has had a very impressive benefit."
At 36 minutes: "In fact, that's why we're here. So we want you to be calling us so that we can help manage these things. But I think with these new apps, I mean, it's really nice because they're also trying to do what you were suggesting is teach the patients also how to manage some of these things. So if you tell the app that, 'I've actually had two bowel movements today,' the app can tell you back, 'Well, please take two tablets of Imodium,' for example, and see now how you respond to that."
Disclaimer: All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
This episode is sponsored by Gilead Oncology. Gilead had no involvement or input in the podcast content. Gilead Oncology is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.
YouTube Tags:
Triple-negative breast cancer (TNBC), Early-stage breast cancer treatment, Metastatic TNBC advancements, Pathologic complete response (PCR), Antibody drug conjugates (ADC), Immunotherapy in breast cancer, Biomarker testing for cancer, PARP inhibitors in cancer therapy, Patient-reported outcomes in oncology, Symptom management during cancer treatment