Dr. Peter Hosein is an oncologist at Sylvester Comprehensive Cancer Center. For more information on treatments for pancreatic cancer or to make an appointment, call 305-243-1000 or visit the University of Miami's health news blog.
Irma Infante was diagnosed with pancreatic cancer last fall after lingering nausea and stomach pain prompted her gastroenterologist to prescribe a series of scans. Irma assumed her symptoms were the result of an ongoing battle with gastritis. The diagnosis sent her reeling.
“Just like that, you have cancer,” she says. “It felt surreal. I thought he was talking to someone else.”
The first oncologist to meet with Irma following her diagnosis said her chances of long-term survival were slim. The cancer had already spread to her abdominal wall, and Stage 4 pancreatic cancer has a reputation for being difficult to treat.
But the bleak news steeled Irma’s resolve. “I decided at that moment I was not going to give up,” she says. “I was not going to sit here and wait for things to happen. I was going to get a second opinion.”
Irma made an appointment with Dr. Peter Hosein, an oncologist at Sylvester Comprehensive Cancer Center who specializes in pancreatic cancer. ”I remember very clearly telling her on the first visit that there’s a chance we might be able to get rid of her cancer,” says Dr. Hosein.
Through genetic testing prescribed by Dr. Hosein, Irma learned that she is a carrier of the BRCA gene mutation, most commonly associated with breast and ovarian cancers. As a result of this finding, Dr. Hosein was able to customize a treatment program for Irma, beginning with chemotherapy. “Because of the BRCA mutation, the specific chemotherapy medication that she received actually works better than if you did not have the BRCA mutation,” he says.
After 11 rounds of chemotherapy, Irma showed no signs of cancer anywhere in her body. To keep the cancer from returning, Dr. Hosein enrolled Irma in the TAPUR (Targeted Agent and Profiling Utilization Registry) Study sponsored by the American Society of Clinical Oncology.
The study, offered at 113 sites across the country including Sylvester, matches patients with targeted therapies based on their genomic profile. The study provides access to drugs that are FDA approved for use in other types of cancer in patients who have exhausted standard options.
When Dr. Hosein began his oncology practice 15 years ago, patients with late-stage pancreatic cancer had almost no treatment options. Often, their doctors recommended they forgo treatment altogether. But recently there has been a paradigm shift, says Dr. Hosein. Within the last year, the FDA has approved two treatments based on genetics, not based on the tumor location.
Dr. Hosein recommends genetic profiling for all pancreatic cancer patients upon diagnosis. “I always describe to patients two different types of genetic testing: testing on the patient and testing on the tumor. When we have that information, we can use it to select the best chemotherapy for patients and to direct them to appropriate clinical trials.”
“The science is changing so quickly that, if I keep the patient alive for six months, maybe a new treatment option will be available that could make all the difference in the world,” he says. “I have patients who are now two or three years out when, previously, they would be expected to live two or three months.”
A positive attitude and family support often play a role in helping patients push through the mental and physical challenges of the intense chemotherapy regimen prescribed for pancreatic cancer, says Dr. Hosein. Irma has this in spades. She remains remission and attributes her good health to Dr. Hosein and the team at Sylvester. “I didn’t have much hope and he gave me hope again. He gave me faith and he lifted me up,” she says. “He’s an angel on earth.”
The future of pancreatic cancer research is also looking bright at Sylvester. “We have a pancreatic cancer research institute here at Sylvester that has discovered a combination of treatments that appear to be very effective in the lab, and we're actually going to move them into clinical trials in the next few months,” says Dr. Hosein. “Hopefully, that will be applicable to many more patients than just the patients who have a BRCA mutation.”
Survival rates at Sylvester often surpass those of other cancer centers in the country and exceed the expectations outlined by the current research, according to Dr. Hosein. “We think we are seeing better results because of the science behind the work we do,” he says.
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