MY LIFE Matters - Spring 2024 - 23

CONNECTION, PURPOSE, AND LOVE Becoming Empowered
the site was. I thought, I wish I had known
about this as a provider because I know how
clunky and how difficult it is to search for
clinical trials. So, I loved that this was part of
their armamentarium of offerings, and that
they wanted someone to work with them
to increase the much-needed outreach to
diverse populations to be able to use that
tool. At Quantum, the intention was to
increase diversity on all their projects,
including the I-SPY2 breast cancer trial and
the WISDOM personalized breast cancer
mammography screening trial, and that's
how I became involved.
Quantum Leap Healthcare collaborative
was started by a UCSF breast surgeon
named Laura Esserman. She is one of
those people who is incredibly smart and
is an " ideas " person. She spearheaded the
development of I-SPY neoadjuvant breast
cancer trial during its tenure under NCI,
overseeing its operations before it transitioned
to UCSF. Ultimately, she established
the nonprofit Quantum Leap Healthcare
Collaborative in partnership with UCSF
to manage the I-SPY2 breast trial. She
also developed another incredible study
for mammographic personalized screening
for mammography called WISDOM.
WISDOM is a screening study to help determine
the best age and how often breast
screening should be given to patients. This
approach allows for each woman receiving
a personalized mammogram schedule
through a genetic analysis. So, it works to
have personalized screenings, opting for
genetic analysis tailors recommendations
rather than employing a one-size-fits-all
approach to mammographic screening
for everyone. The absolute best part of the
WISDOM study is that is totally decentralDR.
SARA HORTON
Dr. Horton is a board-certified medical oncologist
and the executive director of Access and Diversity
at Quantum Leap Healthcare Collaborative, a
nonprofit dedicated to advancing breast cancer
clinical trials. Holding an affiliate associate
professorship at Howard University Cancer Center,
she brings her expertise to the Transdisciplinary Breast
Cancer Clinic. With a remarkable career spanning over two
decades, Dr. Horton is a trailblazer in addressing
cancer outcome disparities and advocating
for diversity in clinical trials. Her leadership
roles at Howard University Hospital and the
FDA have left an indelible mark on the field,
evident in her numerous papers on disparities
in cancer outcomes among African American
patients. Dr. Horton completed her hematology/oncology
fellowship at the Georgetown
University Lombardi Cancer Center and
currently calls Silver Spring, Maryland, home,
where she resides with her family and two
rescue dogs, Pixie and Mia.
ized, meaning you do not need to go into
a center to register and be on the study.
Everything is online- the registration and
trial information is accessed on a mobile
phone or computer. A kit is mailed to you
to collect the saliva sample for dna genetic
information. This is key in making sure
the trial can be accessible to everyone, no
matter where you live.
The I-SPY2 breast cancer study is a
Both I-SPY and WISDOM are acronyms.
I-SPY Trial: (Investigation of Serial Studies
to Predict Your Therapeutic Response
with Imaging and Molecular Analysis 2).
WISDOM Study: Enabling a Paradigm
Shift: A Preference-Tolerant RCT of
Personalized vs. Annual Screening for
Breast Cancer.
neoadjuvant study. For those unfamiliar
with the term neoadjuvant, it refers to
when people are diagnosed with breast
cancer, they may be given chemotherapy
first try to shrink down the tumor before
doing surgery, mainly to make the surgery
easier to remove all of the tumor.
An important part of giving chemotherapy
first, is that we're able to see how the
tumor responds or doesn't respond. And
so, giving the chemotherapy first, before
removing the cancer, is actually giving us
a lot of information about how well that
chemotherapy works against the cancer
that we don't typically get. When we give
chemotherapy to someone after the tumor
has been removed, it's called in the adjuvant
setting, and because the cancer has
been removed first, we are not able to tell
how well the chemotherapy shrinks the
cancer. An important part of giving neoadjuvant
chemotherapy on ISPY2 is that
if the tumor isn't shrinking as it should
or growing, you can switch to what is
determined to hopefully be a better treatment
based on what we've learned about
tumors similar to that patients. Typically,
if you are not on the ISPY2 study and you
receive neoadjuvant chemotherapy, you
receive one drug combination treatment.
If that treatment doesn't start shrinking
the cancer, chemotherapy is stopped and
you go to surgery, That's what the I-SPY2
trial offers that other trials don't. If the
first set of drugs don't work and the tumor
grows, based on your genetics-the
genome analysis of your tumor-you'll
be randomized to what's called block B,
another set of treatment. Drawing from
experiences of patients with similar genetic
changes in the past, they determine
the most suitable drugs for your specific
profile. So, what we're trying to do is develop,
identify, and create innovative, less
toxic drugs upfront before you have to go
to the standard of care. l
MY LIFE MATTERS
EMPOWERED | SPRING 2024
23
MY LIFE Matters - Spring 2024

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