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For: Baker JL, Hegde J, Thompson CK, Lee MK, DiNome ML. Locoregional Management of Inflammatory Breast Cancer. Curr Breast Cancer Rep 2020. [DOI: 10.1007/s12609-020-00389-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]

For:	Baker JL, Hegde J, Thompson CK, Lee MK, DiNome ML. Locoregional Management of Inflammatory Breast Cancer. Curr Breast Cancer Rep 2020. [DOI: 10.1007/s12609-020-00389-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]

Number

Cited by Other Article(s)

Lynce F, Stevens LE, Li Z, Brock JE, Gulvady A, Huang Y, Nakhlis F, Patel A, Force JM, Haddad TC, Ueno N, Stearns V, Wolff AC, Clark AS, Bellon JR, Richardson ET, Balko JM, Krop IE, Winer EP, Lange P, Hwang ES, King TA, Tolaney SM, Thompson A, Gupta GP, Mittendorf EA, Regan MM, Overmoyer B, Polyak K. TBCRC 039: a phase II study of preoperative ruxolitinib with or without paclitaxel for triple-negative inflammatory breast cancer. Breast Cancer Res 2024;26:20. [PMID: 38297352 PMCID: PMC10829369 DOI: 10.1186/s13058-024-01774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open

Abstract

BACKGROUND

Patients with inflammatory breast cancer (IBC) have overall poor clinical outcomes, with triple-negative IBC (TN-IBC) being associated with the worst survival, warranting the investigation of novel therapies. Preclinical studies implied that ruxolitinib (RUX), a JAK1/2 inhibitor, may be an effective therapy for TN-IBC.

METHODS

We conducted a randomized phase II study with nested window-of-opportunity in TN-IBC. Treatment-naïve patients received a 7-day run-in of RUX alone or RUX plus paclitaxel (PAC). After the run-in, those who received RUX alone proceeded to neoadjuvant therapy with either RUX + PAC or PAC alone for 12 weeks; those who had received RUX + PAC continued treatment for 12 weeks. All patients subsequently received 4 cycles of doxorubicin plus cyclophosphamide prior to surgery. Research tumor biopsies were performed at baseline (pre-run-in) and after run-in therapy. Tumors were evaluated for phosphorylated STAT3 (pSTAT3) by immunostaining, and a subset was also analyzed by RNA-seq. The primary endpoint was the percent of pSTAT3-positive pre-run-in tumors that became pSTAT3-negative. Secondary endpoints included pathologic complete response (pCR).

RESULTS

Overall, 23 patients were enrolled, of whom 21 completed preoperative therapy. Two patients achieved pCR (8.7%). pSTAT3 and IL-6/JAK/STAT3 signaling decreased in post-run-in biopsies of RUX-treated samples, while sustained treatment with RUX + PAC upregulated IL-6/JAK/STAT3 signaling compared to RUX alone. Both treatments decreased GZMB+ T cells implying immune suppression. RUX alone effectively inhibited JAK/STAT3 signaling but its combination with PAC led to incomplete inhibition. The immune suppressive effects of RUX alone and in combination may negate its growth inhibitory effects on cancer cells.

CONCLUSION

In summary, the use of RUX in TN-IBC was associated with a decrease in pSTAT3 levels despite lack of clinical benefit. Cancer cell-specific-targeting of JAK2/STAT3 or combinations with immunotherapy may be required for further evaluation of JAK2/STAT3 signaling as a cancer therapeutic target.

TRIAL REGISTRATION

www.

CLINICALTRIALS

gov , NCT02876302. Registered 23 August 2016.

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Affiliation(s)

Filipa Lynce Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA. Harvard Medical School, Boston, MA, USA. Brigham and Women's Hospital, Boston, MA, USA.
Laura E Stevens Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Zheqi Li Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Jane E Brock Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Anushree Gulvady Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Ying Huang Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Faina Nakhlis Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Ashka Patel Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Jeremy M Force Duke University, Durham, NC, USA
Tufia C Haddad Mayo Clinic, Rochester, MN, USA
Naoto Ueno MD Anderson Cancer Center, Houston, TX, USA
Vered Stearns Johns Hopkins University, Baltimore, MA, USA
Antonio C Wolff Johns Hopkins University, Baltimore, MA, USA
Amy S Clark University of Pennsylvania, Philadelphia, PA, USA
Jennifer R Bellon Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Edward T Richardson Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Justin M Balko Vanderbilt University Medical Center, Nashville, TN, USA
Ian E Krop Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA Yale Cancer Center, New Haven, CT, USA
Eric P Winer Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA Yale Cancer Center, New Haven, CT, USA
Paulina Lange Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA
E Shelley Hwang Duke University, Durham, NC, USA
Tari A King Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Sara M Tolaney Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Alastair Thompson Baylor College of Medicine, Houston, TX, USA
Gaorav P Gupta University of North Carolina, Chapel Hill, NC, USA
Elizabeth A Mittendorf Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Meredith M Regan Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA
Beth Overmoyer Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA Harvard Medical School, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA
Kornelia Polyak Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA, 02215, USA. Harvard Medical School, Boston, MA, USA. Brigham and Women's Hospital, Boston, MA, USA.

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Garrido-Castro AC, Regan MM, Niman SM, Nakhlis F, Remolano C, Rosenbluth JM, Block C, Warren LE, Bellon JR, Yeh E, Harrison BT, Troll E, Lin NU, Tolaney SM, Overmoyer B, Lynce F. Clinical outcomes of de novo metastatic HER2-positive inflammatory breast cancer. NPJ Breast Cancer 2023;9:50. [PMID: 37268625 DOI: 10.1038/s41523-023-00555-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 05/19/2023] [Indexed: 06/04/2023] Open

Affiliation(s)

Ana C Garrido-Castro Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Meredith M Regan Harvard Medical School, Boston, MA, USA Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
Samuel M Niman Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
Faina Nakhlis Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
Claire Remolano Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Jennifer M Rosenbluth Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
Caroline Block Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Laura E Warren Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Jennifer R Bellon Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Eren Yeh Harvard Medical School, Boston, MA, USA Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
Beth T Harrison Harvard Medical School, Boston, MA, USA Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
Elizabeth Troll Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
Nancy U Lin Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Sara M Tolaney Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Beth Overmoyer Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Filipa Lynce Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA. Harvard Medical School, Boston, MA, USA.

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