Angela's Interview & Publication
SYNLAB UK & Ireland
Angela Cramer
Lead Clinical Scientist, Breast and Gastric Cancer, at The Christie NHS / SYNLAB (CPP)
What inspired your research and what did it cover?
It is always an honour to be asked, as a clinical scientist, to contribute to clinical trials. The EPHOS-B trial (The Institute of Cancer Research, London) was a UK collaboration involving many laboratories and hospitals. We at SYNLAB were chosen to do the proliferation studies due to our extensive experience in immunohistochemical staining and interpretation.
Looking at the potential of your findings, what difference can they make?
It took a lot of effort, over many years, and the results achieved were remarkable. In some cases, using targeted treatment (trastuzumab or lapatinib or a combination), we were able to prove a complete or partial shrinkage of tumours in HER2-positive breast cancer patients. The positive effects were achieved with perioperative treatment in the eleven days from biopsy to surgery. These impressive findings mean that some patients may be spared unpleasant chemotherapy.
Publication
Combined Perioperative Lapatinib and Trastuzumab in EarlyHER2-Positive Breast Cancer Identifies Early Responders: Randomized UK EPHOS-B Trial Long-Term Results
National Library of Medicine – https://pubmed.ncbi.nlm.nih.gov/35165099/
The Ephos-B trial was a multicentre study involving 257 HER2 (epidermal growth factor 2) positive patients. The aim of the study was to determine whether 11 days of treatment with anti-HER2 therapy before surgery could inhibit proliferation (Ki67) or increase apoptosis. The 3 treatment groups were control, trastuzumab/lapatinib combined, trastuzumab. The strongest response to Ki67 (>30%) was observed in the combined group (74% of cases), 40% in the trastuzumab group and 6% in the control group. Tumour disappeared completely in 6 patients and cancer cell burden was minimal in 13. No increase in apoptosis was observed in any of the groups.