Expert Discusses Biosignature Model's Potential in Predicting Therapy Response in Early-Stage Breast Cancer

Troy Bremer, PhD, chief scientific officer at PreludeDx, discusses biosignature model and it's potential in predicting radiation therapy response for those with early-stage invasive breast cancer.

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Q: Can you provide an overview of the biosignature discussed in the poster and its potential significance in predicting radiation therapy response in early-stage invasive breast cancer?

Troy Bremer: Patients with early-stage invasive breast cancer today have an excellent outcome for survival, and we're doing better than we ever have before. In many cases, those patients can have a recurrence that occurs much later in time than what you would typically consider within a five-year period, where you're evaluating a lot of drug therapy, and so in these cases, radiation therapy still plays a critical role in helping to reduce those recurrences locally, and in doing so improve the quality of that patient's life, which is really the goal of these therapies that are not associated with survival. This biosignature helps identify those patients who have late-stage failure in time and helps better prepare the identification of those patients to receive an appropriate treatment, and again, this is poor an improvement in the quality of life over a decade, and not just the survival over a limited period of time.

Q: Can you discuss how biosignature works and its implications for tailoring radiation therapy decisions for individual patients?

Troy Bremer: This biosignature is one part of a more comprehensive test, and here we're showcasing these 2 independent axes. One is really associated with proliferation and metabolism, and the other is associated with the immune response of the body to the tumor, and in this case, the interaction of those 2 is identifying patients who have a excellent outcome with breast conserving surgery and radiation therapy. Those who are benefiting strongly compared to flee for the when they were not treated, versus when they were treated with radiation therapy. It's also identifying a subset of patients who with standard radiation therapy, the dose was inadequate to get a good response, and you still had a late failure. By identifying these 3 groups of patients, those who are really at a lower risk, those who are benefiting strongly from radiation therapy, and those who have a lower response to radiation therapy, can better tailor the choices for treatment in conjunction of course with the multidisciplinary team and radiation oncology.

Q: How can the results of the study better inform pharmacists and health care professionals counseling and recommendations for patients undergoing breast-conserving surgery?

Troy Bremer: Breast conserving surgery is the mainstay of treatment for these early stage patients, and is an excellent therapy that reduces a lot of the risk. In a subset of patients, there are remaining risks, and in many of these early-stage patients, the risk is not about survival any longer, but it's really about managing a recurrence. For the identification of those patients, in counseling those patients, you can now more easily explain why an additional therapy is needed, when there's an awful lot of discussion about how this type of therapy may no longer be needed, but for these patients radiation therapy can be a strong beneficial factor, and also can improve the quality of life over time.

Q: How can pharmacists and health care professionals contribute to patient education and adherence to radiation therapy regimens based on the biosignature results?

Troy Bremer: When you discuss early-stage breast cancer, the reason that there needs or different treatments is not all breast cancer, even though it's early stage is the same. As health care providers counsel those patients that while they have early-stage disease, we have improved means of identifying the risks of their individual disease rather than just an aggregate population study. This can help the patient understand that they have specific needs in order to best treat their disease, and that can enable them to be more compliant and receive the therapy that they need.

Q: Is there anything you would like to add?

Troy Bremer: To the test that's been in development for a number of years, we plan to release next year, and this is going to be available with more extensive validations in progress, to be able to help address the identification of these patients who can really benefit from standard or more aggressive radiation therapy, although these patients are early-stage breast cancer patients. My position in Prelude is the Chief Science Officer. It's our goal to help identify through the use of these technologies, the individual profiles of risk and benefit for tailoring treatment for patients so they can have a better quality of life and they're able to receive the appropriate treatment for their cancer.