Regenerative Medicine and Stem Cells Technologies

On Thursday morning, Oct. 6, Mike Moore, a pharmacy technician at UCHealth Yampa Valley Medical Center in Steamboat Springs, was busy preparing immunotherapy prescription medicine.

Moore reconstituted a dose of an immunotherapy medication that is used to fight breast cancer by alerting the immune system to destroy cancer cells.

Shortly afterward, registered nurse Amy Lawton hung the intravenous therapy bag of immunotherapy medicine on an IV stand at UCHealth Jan Bishop Cancer Center. Lawton programmed an infusion pump to accurately deliver a course of immunotherapy for the next patient.

As researchers have learned more about breast cancer, including identifying five molecular subtypes, treatments have become more targeted and personalized to each type and stage. One of those targeted advances is immunotherapy, which is available at the cancer infusion center in Steamboat Springs.

According to the American Cancer Society, immunotherapy can boost or change how the immune system works to find and attack cancer cells.

With the increasingly improved understanding of the biology of breast cancer, researchers are creating specific therapies for each woman’s disease type, said Dr. Chelsea Gawryletz, the medical director of the breast cancer and breast cancer research programs at UCHealth Cancer Care and Hematology Clinic at Harmony Campus in Fort Collins.

“Now types of cancer are very treatable, and we can treat with different targeted therapies such as pills, infusions and injections, harnessing the patient’s own immune system that can be activated to fight the cancer,” Gawryletz said.

Gawryletz has a passion for discussing innovations in breast care treatments, especially in the context of those living with metastatic breast cancer. She talked about novel treatments in HER2+ breast cancer and metastatic triple-negative breast cancer.

“Both are exciting and fast-moving areas of breast cancer research, both leading to new cancer therapies and combinations of therapies for these patients,”

Gawryletz said. “We are seeing these novel breakthroughs achieve FDA approvals.”

Immunotherapy has progressed in the treatment of advanced stage 4 breast cancer, but Gawryletz also is excited about current advances in that therapy for early-stage breast cancer.

“Immune therapy for early-stage triple-negative breast cancer is a paradigm shift for women effected by this aggressive type of breast cancer,” she said.

Shannon Fonger, a nurse practitioner who specializes in medical oncology at Jan Bishop Cancer Center, estimated 10-15% of patients are utilizing immunotherapy at the local cancer center. She said the treatments help the body recognize and attack cancer cells as foreign objects.

Immunotherapy can be combined with chemo therapy or used alone as maintenance therapy to keep cancer in check during a time of surveillance, Fonger said.

“We are continuously learning more about how to treat cancer now and reduce the risk of it coming back later,” Fonger noted.

Fonger emphasized that cancer patients in Steamboat can receive the same progressive infusion treatment as available on the Front Range, with the exception of clinical trials.

“We are able to provide very high-level treatments here in Steamboat,” Fonger said. “We have the expanded connections with the UCHealth system to work together.”

Experts say chemotherapy drug options are also improving and expanding.

“We have newer drugs that target various pathways that hopefully have less side effects than traditional chemotherapy and leave individuals to have a high quality of life,” Fonger said. “We have advancements in chemotherapy drugs that are linked to antibodies so they help deliver the drug to the target, or the cancer cells, as opposed to throughout the body that can cause more side effects.”

Many of the recent advances treat stage 4 or metastatic breast cancer where cancer cells have spread to other parts of the body.

“Stage 4 by definition we don’t cure, but we treat. We do see prolonged remissions even in stage 4,” Gawryletz

said. “Even if it’s metastatic, women can live many years as a chronic condition that is very treatable.”

More than 90% of breast cancer can now be cured if caught early, even aggressive types, Gawryletz said, but she emphasized regular mammograms are still critical to catching breast cancer early. Women age 40 and older are recommended to receive annual mammograms, she noted, adding that more than 270,000 new cases of breast cancer are diagnosed in the U.S. each year.

While Gawryletz can quickly delve into many technical variables for the subtypes and new combinations of treatments for breast cancer, her take-home message was positive for patients. Current treatments can target receptors for breast cancer with more accuracy and more management of side effects.

“A little over half of breast cancers are of the more aggressive subtype, but aggressive breast cancer often responds well to a combination of chemo, targeted and immune therapies,” she noted.

“We are at a rapid pace of exploration in breast cancer novel treatment,” the physician said. “We are making significant breakthroughs now that are helping breast cancer patients. I believe we are at large inflection point

for novel therapies to come from the bench top to the bed top.”