Laura Esserman, MD, MBA, Professor, University of California, San Francisco, discusses screening patients with higher-risk DCIS.

Chloroquine is an interesting agent, Esserman says, that may have the biologic properties to help a tumor self-destruct. A potentially-beneficial strategy may be to administer the drug for one to two weeks, then operating to determine if a patient is hitting the target or to identify a biomarker. As no drug exists that prevents ER-negative or hormone-negative disease, there is no reason not to test in this way, Esserman says.

In the case of agents like zoledronate, Esserman believes that it is a great idea to conduct a window trial to selectively screen patients with higher-risk DCIS and look for an impact.

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Dr. Esserman on Screening Patients With Higher-Risk DCIS

Laura Esserman, MD, MBA, Professor, University of California, San Francisco, comments on the findings from the I-SPY 1 trial and the basis for the I-SPY 2 trial in patients with breast cancer.

From the I-SPY 1 trial, researchers and physicians found out how to get all biomarkers off of a single core and that it was possible to work together to share data and bio-specimens. Not only did pathologic complete response translate into a better outcome for survival and recurrence, it also proved to be a much better signal for different disease subsets.

Rather than analyze subsets retrospectively, Esserman says, physicians should sort out data from the beginning to know for whom and in which subset new drugs might work.

Laura Esserman, MD

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Dr. Esserman on Screening Patients With Higher-Risk DCIS

Dr. Esserman on the I-SPY 2 Trial in Breast Cancer