Adrienne Gropper Waks, MD
Dana-Farber Cancer Institute
Following many important advances in treating HER2-positive breast cancer over the past two decades, a large majority of patients with non-metastatic HER2-positive tumors are cured with today’s treatments. For this majority of patients who do well in the long-term, we must begin to identify ways to cure HER2-positive breast cancer with less toxic treatments.
Modern treatment regimens for stage II and III non-metastatic HER2-positive breast cancer consist of multiple chemotherapy agents plus HER2-directed therapy with trastuzumab (Herceptin, H) and sometimes pertuzumab (Perjeta, P). Scaling back the number of chemotherapy agents used may allow patients to maintain better quality of life while on treatment, as well as decrease the chance of rare but serious chemotherapy complications.
As a Terri Brodeur fellow, Dr. Waks plans to conduct a clinical trial investigating a new treatment approach in stage II and III HER2-positive breast cancer, with the goal of allowing select patients to receive less chemotherapy.
We know that in patients who receive breast cancer treatment before breast surgery, those who have all cancer eradicated from the breast and lymph nodes at the time of surgery (“pathologic complete response”) have an excellent prognosis. In our clinical trial, patients will be treated before surgery with paclitaxel, trastuzumab, and pertuzumab (“THP”), and those who achieve pathologic complete response at surgery—and have an excellent prognosis on that basis—will go on to receive further HP post-surgery, without any additional chemotherapy. Our primary goal in the trial is to assess the acceptability of this treatment approach to patients and their doctors. We hope that this trial, which is a precursor to a large international trial investigating the same approach, will be a step toward establishing HER2-positive breast cancer treatments that are highly effective for a select patient group, and also maximize patient quality of life.
Dr. Waks conducted her undergraduate studies at Princeton University and then obtained her M.D. degree at Harvard Medical School. She completed residency training in internal medicine at Brigham and Women’s Hospital in Boston, MA, where she was selected to serve for an additional year as a Chief Resident in internal medicine. She is currently a clinical and research fellow in medical oncology at Dana-Farber Cancer Institute, where she will shortly join the staff as an attending physician in breast oncology at the Dana-Farber Susan F. Smith Center for Women’s Cancers, and an instructor at Harvard Medical School.