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A Treatment on Trial: Woman Participates in Study of Potential Cancer Vaccine

Posted on: Monday, 3 April 2006, 03:02 CDT

By Elizabeth Giorgi, Reading Eagle, Pa.

Apr. 2--WHEN RITA N. COCUZZA of Wyomissing was diagnosed with breast cancer, she knew what her options were.

She had seen her grandmother battle breast cancer, and her sister was in treatment for the disease.

And she knew that the ductal cancer she had could show up in either breast.

"I probably would have opted for a double mastectomy," said Cocuzza, who is in her early 50s.

But before she underwent surgery, she decided to follow through on a vow she made after watching her sister's treatment.

"I always thought if I had cancer, I would go out of the area to get a second opinion," she said.

Her decision had life-changing effects.

A neighbor recommended the University of Pennsylvania cancer center in Philadelphia. There she learned that she was eligible for a research trial that could not only replace radiation treatment and reduce her need for surgery, but one day might lead to a vaccine against the disease.

This winter, Cocuzza took part in the trial conducted by Dr. Brian Czerniecki, surgical director of the university's Rena Rowan Breast Center in the Abramson Cancer Center.

She is due for follow-up testing this summer, but said the treatment was successful.

The trial involves women who are in the early stages of ductal carcinoma in situ, cancer in the breast ducts that has not invaded the fat tissue around it, and whose cancer is associated with cells that produce too much of a protein called Her/2neu.

The trial involves removing certain white blood cells from the patient, activating them to create an immune response to the protein and injecting them back into the patient.

The body's immune system then attacks the cells that overexpress the protein, reducing the size of the tumor. Women in the trial then have surgery to remove the rest of the tumor.

Cocuzza said the success other women had seen with the trial convinced her to take part. She said she was told that of six women who had taken part before her, some had as much as 70 percent of the cancer gone before surgery.

"There's risk to cuttingedge treatment," Cocuzza said. "(But) I was doing something that sounded very logical to me."

Cocuzza received treatments once a week for four weeks. In each, activated cells were injected directly into the lymph nodes in her groin.

The two injections took about 5 to 10 minutes to administer, during which time, Cocuzza said, she could watch the needle going into her lymph nodes on an ultrasound screen.

She said she tried to focus only on the positive aspects of the treatment.

"I went in there with the mindset that I was going to tolerate whatever happened, because it meant my life," she said.

She said the injections resulted in flu-like symptoms, including fevers and fatigue for up to three days afterward.

"But when you consider other treatments, that's minimal," she said.

Cocuzza said Czerniecki found that the treatment generated an immune response in her, but he could not measure reduction of her tumor because of complications from an attempt to remove the cancer when it was biopsied and diagnosed.

The trial has been going on for more than a year and likely will finish in another year or year and a half, Czerniecki said.

"For some people, it might spare surgery altogether," he said of his hopes for the future.

The trial may have ramifications for more than just women with Her/2neu-related cancer, Czerniecki said. Down the line, the treatment may be used on other cancers that are caused by similar protein overexpression.

Cocuzza said she was honored to take part in the study, which is adding to research that may one day result in a vaccine against breast cancer.

Additionally, she said, the trial helped her avoid more radical treatments like a mastectomy.

"If you have a mastectomy, the psychological ramifications are much greater," she said. "I mean, that's huge to go through, what it does to your body. I really felt for the people who were not as lucky as me."

Contact reporter Elizabeth Giorgi at 610-371-5016 or egiorgi@readingeagle.com.

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Source: Reading Eagle

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