Compass Trial: A new way to fight breast cancer

PARK RIDGE, Ill. — A new approach to cancer treatment is to reduce short- and long-term toxic side effects while reaping the benefits of a powerful treatment regimen.

Local doctors are testing the concept of lower-dose chemotherapy, in some cases even eliminating the drug, in breast cancer patients.

Less may not be more, but it may be enough to fight the disease.

After another needle stick, almost a year later, this is Lana Callahan’s last treatment.

A 43-year-old woman has two positive tests breast cancer.

“Her two positive tumors are more aggressive,” said Dr. Christy Hancock. “They love to come back. They like to return to bad places, to the brain, liver, lungs.”

Callahan said she was very lucky it didn’t spread to her lymph nodes.

For patients like Callahan, and those with triple-negative tumors, the standard treatment usually consists of six cycles of chemotherapy with four different doses, including one of carboplatin, which is known to cause significant side effects.

“This regiment is pretty tough,” Hancock said.

Patients may experience nausea, vomiting, and general fatigue and weakness. Diarrhea is a serious problem.

“One in five patients end up in the hospital, where they are given intravenous fluids and continued support, so it’s very toxic,” said Dr. Sigrun Hallmayer.

And some medicines can damage the bones and vital organs, the heart, lungs and kidneys can be affected.

“I did my research and made a decision. It was the best decision for me,” Callahan said.

Hoping to avoid the toxicity of standard treatment, Callahan opted for a clinical trial at Advocate Lutheran Hospital in Park Ridge, where medical oncologists are testing the effectiveness of fewer cycles of chemotherapy and fewer drugs.

More precisely, the exclusion of carboplatin from the treatment regimen.

“What I liked about this trial is that the chemotherapy is a little less, the chemotherapy was not zero,” Callahan said.

Callahan received three drugs in her chemotherapy cocktail before and after her double mastectomy, hoping to achieve the same results as patients who received standard treatment.

“We can feel the disease, and many of these patients will have visible tumors, and I’ve seen that in my practice, very often when they come back for a second, third or fourth cycle,” Hallmeier said. “And their breast exam has already come back completely normal, so the question is, do we really need to do cycle 5, cycle 6? Do we really need all 4 drugs to achieve this result?”

It is called Compass testdoctors at several research centers are tracking how well the reduced therapy holds up.

“We still want to cure all these patients with aggressive breast cancer, but can we achieve a curative outcome using less therapy, at least initially,” Hallmeier said.

For the busy mum, the experiment meant she could be well enough to work and take care of her family throughout treatment.

“It’s hard. You feel tired, exhausted, your body is struggling and it’s hard. It’s hard to be a good mom during this time, but in the long run, I wanted to make sure I was there for them,” Callahan said.

Hancock said she is advocating for herself and the reduction in treatment was successful.

“So, at best, she got four cycles of treatment and then when she went in for surgery, the cancer was not seen,” Hancock said.

The strategy does not work for every patient. Those who still have residual cancer after surgery require a more aggressive treatment protocol.

I believe that trials are important. I think about my daughter, I think about other women,” Callahan said. “We want to kill the cancer, but we don’t want to damage our body so much that it shortens our life after we’ve killed the cancer.”

Compass Road is still open for registration nationwide.