Hoag trial spells hope for patients battling aggressive form of breast cancer

Norma Marquez distinctly remembers the day she learned she had breast cancer.

“It was May 1, 2018. I was diagnosed on St. Peregrine’s Feast Day,” the 43-year-old Anaheim resident recalled, explaining Peregrine is the Catholic patron saint of cancer sufferers.

A biopsy would confirm an abnormality discovered in Marquez’s mammogram and deliver an especially heavy blow — she had triple-negative breast cancer, a rare-but-aggressive form that moves quickly and resists traditional therapies.

To forestall the worst, Marquez acted quickly.

She underwent a double mastectomy in January 2019 but the cancer, undeterred, spread to her brain. Radiation, chemotherapy, immunotherapy and open brain surgery offered slim rays of hope that faded as scans showed the cancer had reached her liver.

“Each time we think we have it contained, something else pops up,” Marquez said. “Triple-negative breast cancer is one of the most aggressive forms, and unfortunately, right now, they don’t have a cure for it, and they don’t have a lot of options.”

Dr. Chaitali Nangia, oncologist and co-director of NK cellular therapy research for the Hoag Family Cancer Institute.

(Courtesy of Hoag Hospital)

Disproportionately affecting women under 40, Black women and those with the BRCA1 gene mutation, triple-negative breast cancer is not fueled by hormones, rendering hormonal therapy and other traditional treatment options largely ineffective.

But now, a new clinical trial being conducted at Hoag Memorial Hospital Presbyterian could offer hope. It combines low-dose chemotherapy and immunotherapy with the introduction of “natural killer” stem cells, designed to attack and kill cancer, in patients with metastatic triple-negative breast cancer.

The study recently began accepting patients, including Marquez, who began undergoing treatment Sept. 27 and is on the second of 13 three-week therapy cycles.

Dr. Chaitali Nangia, co-director of NK cellular therapy research for the Hoag Family Cancer Institute and the study’s principal investigator, said immunotherapy and the use of stem cells are showing promise in a previously unwinnable battle.

“The NK cell is a type of T-cell — it’s the one that carries on the task of taking the cancer cells out,” Nangia said Tuesday. “So these NK cell therapies are now a deeper dive into the broader umbrella of immunotherapy, a way to kind of say, ‘let’s fix the problem.’”

She described how a combinatorial approach could help train immune systems to recognize NK cells, while introducing healthy cells into a body whose natural supply may have been incapacitated, so patients experience deeper, longer responses to treatment.

Marquez is one of two Orange County residents enrolled in the study, which could grow to 79 patients in the span of a year, depending on initial outcomes. The research period is expected to run through October 2024, with completion of the study anticipated for 2028.

“At this point, what do I really have to lose?” said Marquez, who’s already lived six months past her initial prognosis.

“If, through my experience of going through the clinical trial, this can help other women and give them hope, I’m all for it. I don’t feel like throwing in the towel — there’s a lot to stick around for.”

Nangia is hopeful the study could have long-term implications for the treatment of a heretofore insurmountable diagnosis.

“This is a new frontier in treating triple-negative breast cancer, with the hope of giving our patients durable long-term responses with great quality of life,” she said.

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