Q&A

Dr. Bryan Schneider, a professor at the Indiana University School of Medicine, led a team of researchers in identifying genetic variations that dispose some breast cancer patients to neuropathy when they are receiving chemotherapy with the drug Taxol and similar drugs known as taxanes. Schneider’s research was named one of the biggest advances in cancer research this year by the American Society of Clinical Oncology. The society’s foundation also gave Schneider a three-year, $450,000 grant to further the research.

IBJ: How big of a problem is neuropathy—a burning, tingling, numbness or cold sensation in the extremities—for your patients?

A: For some of my patients it’s a real problem. If they have to type, they have trouble typing. Or if it’s in their feet, they can have troubling walking. Some people would have just absolutely horrible neuropathy after just a dose or two [of Taxol], which not only gave them bad symptoms, but also made it difficult to continue therapy. Then I would walk next door to my next patient, and they would be just fine. That kind of disparity made us believe that there had to be something genetic or something preprogrammed to cause this.

IBJ: You hope your research leads to a blood test that pinpoints which patients have a higher risk of neuropathy. What other treatment options would such patients have?

A: There are some patients that will probably need to receive a taxane given the extent of the disease. But if someone had an extreme risk of neuropathy, one could use a different chemotherapy agent. Many patients are very much on the fence on whether they need chemotherapy. Or not. For the lower-risk tumors, we’re sitting around in the office for an hour trying to determine, is the benefit worth the risk?

IBJ: Beyond today’s existing treatments, how can your insights be used to produce new therapies for patients?

A: We’re taking kind of a layered approach. If we can fine-tune this, it gives us the luxury of telling patients upfront or having doctors pick another chemotherapy agent that doesn’t have this risk. Ultimately, the second layer of this is to develop drugs that either treat or prevent the neuropathy.