Thank you for joining us on the journey to explore cancer recurrence in our series “The Bitch Is Back.” Cancer recurrence rates vary widely depending on the type of cancer and other factors, but occurs in roughly 70% of cancer patients, with higher rates in some of the more common cancers.
To explore this topic, we spoke about the problem firsthand with two women who’ve experienced cancer recurrence, Kathleen and Mary.
The Problem Part One: Kathleen
Kathleen has experienced cancer recurrence three times since her initial diagnosis. She was first diagnosed with Stage Zero breast cancer in 2002. When she learned she had cancer again in 2008, Kathleen described her reaction as, “Oh I have cancer again!” She didn’t even consider it a recurrence, rather she saw it as an entirely unique, secondary event.
However, this second occurrence was an entirely different experience. Instead of a lumpectomy, this time Kathleen endured a single mastectomy and was not a candidate for reconstructive surgery. She describes this first recurrence as “absolutely devastating.” Eight years later, the cancer recurred yet again as Stage 4, and in early 2019 Kathleen was diagnosed once again with a cancer recurrence. This time, Kathleen underwent a mastectomy on her remaining breast.
Kathleen knows better than most how traumatic multiple cancer occurrences can be. Kathleen credits her age with some of her positive attitude, as well as her skilled medical team and advancing technology for her survival. However, she acknowledges that had she been younger, her diagnosis and treatment options would have felt very different. Which is exactly why innovations are needed to treat cancer recurrences.
The Problem Part Two: Mary
Unlike Kathleen, who was nearly 60 at the time of her first diagnosis, Mary was just 23 when she was diagnosed with melanoma. A recent college grad and newlywed, Mary’s first experience with cancer, though treated rather simply, has had a major impact on her entire adult life and perspective.
After 25 years of careful follow up, Mary’s dermatologist told her she no longer needed to get checked every 6 months. But about 7 years after her last cancer follow up, Mary found a lump under her armpit and feared it could be breast cancer. Her physician determined the lump wasn’t in the breast, and following a biopsy, Mary was diagnosed with Malignant Melanoma. The oncologist told Mary that yes, thirty three years later, this was a recurrence of her cancer.
Having been through a cancer diagnosis before, Mary and her husband felt equipped to get through it again. But like Kathleen’s story, this time was much different. While her first treatment had consisted of in-office procedures and recovery at home, the recurrence required a more physically taxing treatment. Mary experienced a variety of difficult side-effects throughout treatment for her recurrence. Having had such a difficult journey following her second diagnosis, the shadow of potential recurrence looms large over Mary.
Mary has responded to her diagnoses admirably, choosing not to sweat the small stuff and focus on living a life of meaning and gratitude.Yet she can’t ignore that her entire adult life has been shaped by her cancer experiences.
To better understand the medical side of cancer recurrence, Ann took time to speak with Dr. Rachna Shroff, Chief, Section of GI Medical Oncology and Leader, GI Disease-Oriented Team at UA Cancer Center, as well as the Director of UA’s Clinical Trials Office
Dr. Shroff broke down and explained the concept of cancer remission and recurrence for our audience. She detailed how cancer stem cells, the “originator cells,” that lead to cancer growth, can be resistant to treatments and lead to recurrence. This is an area of science and oncology that is currently under intense scrutiny and research to provide answers and treatments to cancer patients.
Now that we have a grasp on The Problem and took time to explore it with The Expert, what are some solutions?! We brought in four innovators to discuss their teams and products.
Dr. Anne-Marie Carbonell is working to change the trajectory of cancer recurrence. Dr. Carbonell is Co-Founder and the Chief Executive Officer of OncoSynergy, a trained neurosurgeon, the principal investigator of two active NIH grants, and is a founding member of the Society of Neuro-oncology Committee for Women & Diversity.
Dr. Carbonell’s great frustration is that she and her colleagues “could not cure brain cancer with a scalpel.” They need other, better options.
The fundamental problem with many current approaches to cancer treatments, is that they lead to aggressive recurrence due to the therapeutic resistance. In fact, therapeutic resistance is the number one cause of death in cancer patients. According to Dr. Carbonell, 90% of glioblastoma patients become resistant to first line treatment.
The work being done by OncoSynergy addresses the fundamental cancer driver – cancer’s “achilles heel” – to cut off multiple biological processes simultaneously with a single therapeutic. CD29, a cell surface receptor in the body, is the key gatekeeper between cancer and it’s survival mechanisms. Anti-CD29 therapeutics quarantine the cancer cell from its surrounding microenvironment, effectively cutting off the cancer.
Dr. Carbonell leads the FDA Investigational New Drug approval of OS2966, a first-in-class anti-CD29 (Beta 1 integrin) monoclonal antibody, from pre-clinical stage to phase 1 clinical trials in recurrent glioblastoma.
Darren Cunningham is the CEO of Inflection BioSciences, an early-stage drug development company focused on discovering and developing innovative small molecule therapeutics to treat cancer and cancer recurrences.
One of the most important pathways in cancer occurrence is Pi3 Kinase pathway. It’s implicated in about 40% of all cancers, and it’s a signaling pathway that leads the cell growth and movement. Pi3k targeting and inhibitors are under intense focus for the potential to treat cancer at the source.
Many current treatments are effective at treating the initial PI3K pathway, however, once that route gets shut down it becomes a game of “whack-a-mole.” This is when PIM-Kinase gets activated, causing drug resistance and downgrading outcomes for cancer patients relying on PI3K inhibiting drugs. The cancer simply shifts, leading to difficult to treat recurrence.
In an animal model of cancer, Inflection BioSciences is pleased to report that they continue to add to the data package in support of their PIM/PI3K inhibitor.
Celestra Life Science
David Lu is a research scientist at the Yale Cancer Biology Institute and co-founder of Celestra Life Science. David’s research focuses on lung cancer and drug resistance, which led him to form Celestra. He and his team at Celestra are combining innovations in synthetic lethality and nanotechnology to develop a new class of pan-tumor therapeutic enhancers.
David’s team focuses on the “adaptive response,” where the cancer essentially “re-wires” and finds a new route to attack healthy cells. They are trying to create a universal drug enhancer to combat this adaptive response and keep cancer treatments working longer and more effectively.
What’s unique about Celestra’s goal is the broad application. They hope to create an “add-on” to be used with current therapeutics to stop the deadly aspect of drug resistance.
Richard Austin, CEO/President of Reglagene, a company out to discover and develop low-cost and noninvasive therapeutic solutions that regain control of genes exploited by cancer to keep patients responsive to treatment.
Virtually all cancers are caused by aberrant changes in gene expression. Upon confrontation with therapy, even more genetic changes can occur to enable cancer’s survival.
Reglagene is targeting therapy-resistant cancers (specifically prostate cancer and glioblastoma). Their team is actively studying synergistic combinations with leading cancer therapies to identify the best opportunities for clinical success.
What We Can Do
At CANCER FUND, we understand that more than hope is essential for people like Kathleen and Mary, whose lives are upended by a cancer diagnoses and recurrences. Innovators like OncoSynergy, Inflection BioSciences, Celestra Life Science, and Reglagene hold the key. And your voice matters! Click here to rank these innovators for potential investment by the CANCER FUND.
We provide that solution by investing in cancer startups, closing the gap between the lab and the patient. As a member of this community, your investment provides direct capital to companies who are bringing real innovation to cancer diagnosis and treatment. Learn More Today.