Breast cancer clinical trials at Long Island hospitals offering new hope

Marisa Florio of Middle Island didn't want to know the details of the breast cancer treatment she was about to face. She didn't dwell on her stage 4 diagnosis or the golf-ball-sized tumor in her left breast.

She knew, however, that her prognosis wasn't good when she visited Memorial Sloan Kettering Cancer Center's facility in Commack to meet Dr. Steven Sugarman.

Sugarman's pitch to her: Skip surgery and begin a clinical trial regimen that would include 40 straight weeks of chemotherapy and immunotherapy, a type of treatment that boosts a person's immune system to recognize and fight the cancer.

Florio signed off on the proposal.

"I'm a miracle," said Florio, 39. "In all reality, I shouldn't be here."

Florio is among hundreds of Long Island breast cancer patients who have qualified to participate in clinical trials to either get better outcomes for themselves — or others. Because trials require a statistically significant number of participants in order to judge the success of a drug or treatment, medical researchers often seek participants at multiple health systems around the country.

Seven years into the trial, Florio has no sign of cancer, which also had spread to her liver when she was diagnosed in 2013. She remains on anti-cancer drugs indefinitely as specified by the Memorial Sloan Kettering trial, although the study itself is complete.

"Several of my stage 4 patients who have gone on this trial have done extremely well, and have no signs of cancer," Sugarman, regional care network medical site director for Memorial Sloan Kettering in Commack, said about the trial designed specifically for HER2-positive breast cancer patients. HER2-positive tumors test positive for a specific protein that promotes the growth of cancer cells.

Clinical trials can be cutting edge, such as testing new drugs and therapies on breast cancer patients. Trials also focus on adjusting the intensity or length of care already established.

Health experts caution, though, that cancer patients should talk to their medical providers or visit clinicaltrials.gov for more information about trials, including which ones they'd qualify to participate in.

Clinical trials are broken into three phases. Phase one generally includes only a small group of testers to see if a drug is safe for human use. Phase two pulls in a larger group of testers, all of whom receive the treatment. In phase three, which can involve thousands of patients, some get the test treatment, while others get traditional care.

Patients generally do not have to pay extra for treatments studied as part of a trial. In most cases, cancer patients also aren't compensated for participating in a trial.

Sugarman said Memorial Sloan Kettering has 33 trials available to breast cancer patients on Long Island, where MSK operates centers in Commack and Uniondale, at the Nassau Hub. There are other breast cancer trials available at MSK's flagship in Manhattan.

New Hyde Park-based Northwell Health has between 20 and 30 breast cancer trials, said Dr. Jane Carleton, associate chief of clinical affairs at the health system's Monter Cancer Center. Carleton said patients are still being enrolled in some of the trials, and others have completed therapy and are being monitored.

NYU Langone has about 15 breast cancer clinical trials, said Dr. Sylvia Adams, director of the breast cancer center at the health system's Perlmutter Cancer Center.

Catholic Health Services, which operates six hospitals in the region, expanded its cancer care services recently. Catholic Health last year became a research affiliate of Buffalo-based Roswell Park Comprehensive Cancer Center, which brought more clinical trials to its patients on Long Island, said Dr. Bhoomi Mehrotra, chair of cancer services for Catholic Health Services.

Among the trials Catholic Health Services participates in is one that takes a closer look at the role nutrition and exercise play in "the survivorship of patients who currently don't show any signs of cancer," Mehrotra said.

Catholic Health Services also participates in a new immunotherapy-and-chemotherapy-based trial to treat triple negative breast cancer, a sometimes harder-to-cure cancer that doesn't feed off estrogen, progesterone or by the HER2 protein that feeds other breast cancers.

Another trial examines if taking aspirin for five years after treatment slows recurrence, Mehrotra said. That trial is available at numerous area health systems, including Stony Brook Medicine and NYU Langone.

Bridget DeSimone, 28, of Bethpage, a patient at the Perlmutter Cancer Center at NYU Winthrop Hospital, said she is on that trial because "I want to help the next ones in line. I have a daughter, and by the time she comes of age for screening, I hope breast cancer is a thing of the past."

Stony Brook University Cancer Center participates in the aspirin trial. The health system also is prepared to be part of a National Cancer Institute trial to see the effect of an anti-inflammatory drug — Sulindac — to reduce breast density, an established risk factor for breast cancer. That trial is slated to open later this year.

Other trials at Stony Brook include testing to see if fewer "cycles of chemotherapy are as effective for patients" with a specific type of cancer, said Dr. Alison Stopeck, Stony Brook's chief, division of hematology and oncology.

Kristin Roberts, 38, of Oakdale, has been on four clinical trials under Stopeck's watch since being diagnosed with stage 4, triple negative breast cancer five years ago.

One of those trials tested if an immunotherapy drug — Keytruda — approved for use in lung cancer as well as other cancers could help shrink her tumors. The good news: It did, but there were side effects. Roberts had autoimmune reactions, and had to stop taking the drug.

Still, Roberts said, "I keep asking Dr. Stopeck about what trial I can go on next."