The POETIC-1 trial, the largest of its kind in the world, showed that introducing hormone therapy before surgery, identifies those patients who will respond well to this treatment without the need for additional chemotherapy. POETIC-2 is studying why some patients do not respond and how we can improve treatment for this group of patients. A biopsy is taken two weeks into hormonal treatment to see which are not responding well. A biomarker profile is conducted so we can identify what additional drug might be matched to that biomarker and introduced to treatment. Currently, these additional drugs are only used if metastatic cancer develops after surgery. One of our aims is to discover if introducing them earlier in the treatment process can have better long-term benefits for patients and save more lives.
The full trial design is complex and needs to recruit several hundred patients. The Le Cure grant funds a 2 year feasibility study. To date, Dr Leal has demonstrated the feasibility of recruitment. In the laboratory at The Royal Marsden they were able to deliver accurate molecular analysis of each patient’s cancer within a week of starting treatment. From analyses of tumours from earlier studies, they have worked out the most appropriate molecular signatures for resistance to treatment. Dr Leal is currently analysing tumours from patients previously treated with hormone therapy to see if the signatures that she identified are present in the tumour at the end of treatment. This will show the proportions of patients that are likely to be most sensitive to each of the drug treatments they plan to assess in the main trials.
The main results of the feasibility study were presented recently at the UK Interdisciplinary Breast Cancer Symposium.