Inside Indiana's Fight Against Breast Cancer
The battle against breast cancer is being fought with remarkable ingenuity in labs and clinics across Indiana, where science is creating a future filled with more survivors.
Imagine a future where a breast cancer diagnosis is not met with fear, but with a meticulously personalized plan of attack. Where therapies are tailored to the unique genetic makeup of a patient's tumor, minimizing side effects and maximizing hope. This is the future that researchers across Indiana are building today. Fueled by a powerful combination of cutting-edge science, collaborative spirit, and a deep commitment to patients, the state has become a nationally recognized hub for breast cancer research. From pioneering new immunotherapies to addressing the disparities that affect outcomes, Indiana's research centers are on the front lines, turning groundbreaking discoveries into life-saving realities 1 2 .
A nationally designated cancer center fostering transdisciplinary research where insights from basic science, clinical trials, and population health converge 2 .
A nonprofit providing infrastructure for clinical trials across Indiana, connecting community oncologists with academic researchers .
Understanding breast cancer is the first step toward defeating it. We now know that breast cancer is not a single disease, but a collection of diseases with different drivers and behaviors. Key risk factors include genetic mutations, such as those in the BRCA1 and BRCA2 genes, which significantly increase lifetime risk 4 . Other factors include hormonal influences, lifestyle choices, and reproductive patterns 4 .
This understanding has led to the era of precision medicine, where treatment is guided by the specific characteristics of a patient's tumor.
Central to personalized approaches are biomarkers—biological molecules that indicate a specific state of a cell. For example:
| Subtype | Key Biomarkers | Common Treatment Strategies |
|---|---|---|
| HR+/HER2- | Estrogen and/or Progesterone Receptor Positive | Hormone therapy (e.g., tamoxifen, aromatase inhibitors) 6 |
| HER2+ | HER2 Protein Overexpressed | Targeted anti-HER2 therapy (e.g., trastuzumab, pertuzumab, Enhertu) 6 9 |
| Triple-Negative (TNBC) | ER-, PR-, HER2- | Chemotherapy, Immunotherapy (e.g., Keytruda), Antibody-drug conjugates (e.g., Trodelvy) 6 |
To truly appreciate how research transforms care, let's examine a recent landmark clinical trial with significant contributions from the Indiana oncology community: the INAVO120 study 6 .
To determine if adding inavolisib to the standard two-drug regimen of Ibrance (palbociclib) and Faslodex (fulvestrant) could improve outcomes for patients with PIK3CA-mutated, hormone receptor-positive, HER2-negative advanced breast cancer.
Patients with cancer that had worsened during or after endocrine therapy. The PIK3CA mutation is a common driver of cancer growth.
| Outcome Measure | Inavolisib + Ibrance + Faslodex | Placebo + Ibrance + Faslodex |
|---|---|---|
| Improvement in Overall Survival | ~7 months longer | - |
| Delay in Need for Chemotherapy | ~2 years | - |
| Objective Response Rate (ORR) | ~63% | ~28% |
The nearly two-year delay in the need for chemotherapy is a particularly meaningful outcome for patients, as it allows them more time on a targeted, often better-tolerated regimen. An expert involved in the research, Dr. Nicholas Turner, stated that these findings "support an inavolisib-based regimen as an emerging new standard of care that helps people live longer, as well as substantially improves how long treatment works" 6 .
The breakthroughs emerging from labs in Indiana and worldwide rely on a sophisticated toolkit of research reagents. These tools allow scientists to detect, analyze, and understand the molecular machinery of cancer cells.
| Research Tool | Primary Function in Research | Example Target/Use |
|---|---|---|
| Anti-HER2 Antibodies | Detect HER2 protein overexpression on cancer cells; used for diagnosing HER2+ breast cancer 9 . | HER2/ErbB2 Receptor |
| Anti-Ki67 Antibodies | Identify rapidly proliferating cells; a high Ki67 level often indicates a more aggressive cancer 9 . | Ki67 Nuclear Protein |
| Anti-E-Cadherin Antibodies | Assess loss of cell adhesion; loss of E-Cadherin is associated with cancer invasion and metastasis 9 . | E-Cadherin Protein |
| IHC Kits | Kits used to visualize the presence and location of specific proteins in tissue samples (Immunohistochemistry) 9 . | Various cancer biomarkers |
| ALDEFLUOR™ Assay | Identify and isolate cancer stem cells, which are thought to be responsible for recurrence and metastasis 5 . | Aldehyde Dehydrogenase (ALDH) Enzyme |
The pace of innovation shows no signs of slowing. The 2025 ASCO meeting highlighted several other studies that promise to reshape patient care, many of which are being explored in Indiana-based clinical trials 3 6 :
The DESTINY-Breast09 trial showed that the combination of Enhertu and Perjeta is more effective as a first treatment than the current standard chemotherapy regimen for metastatic HER2+ breast cancer 6 .
For metastatic HR+ breast cancer that develops an ESR1 mutation after initial therapy, the SERENA-6 trial found that switching to the oral drug camizestrant significantly improves outcomes 6 .
The non-hormonal drug elinzanetant was shown in the OASIS-4 study to effectively reduce the debilitating hot flashes that often accompany hormonal therapy 6 .
Identification of BRCA1 and BRCA2 genes and their role in breast cancer risk 4 .
Development of HER2-targeted therapies transforming outcomes for HER2+ breast cancer 9 .
Introduction of checkpoint inhibitors for triple-negative breast cancer 6 .
Routine biomarker testing guiding personalized treatment plans for all breast cancer patients.
Focus on overcoming resistance, managing long-term side effects, and addressing health disparities.
The story of breast cancer research in Indiana is one of relentless progress and profound hope. It is a story written by dedicated scientists in lab coats, compassionate clinicians at the bedside, and courageous patients in clinical trials. From the fundamental research into cancer biology at the Vera Bradley Foundation Center to the practice-changing results of global trials like INAVO120, the collective work is building a future where breast cancer is not a devastating diagnosis, but a manageable condition.
The path forward is clear: more personalized therapies, a greater focus on overcoming treatment resistance, and an unwavering commitment to ensuring that every patient, regardless of race, ethnicity, or geography, has access to these life-saving advances. The research happening today in the heart of the Midwest is not just about fighting a disease—it's about securing a future filled with thriving survivors 1 .