In 2003, oncologist Dr. Rita Mehta had “the kind of
moment everyone lives for” – everyone, that is, who’s working to find a
cure for cancer.
Mehta, a health sciences associate professor of medicine at the
Chao Family Comprehensive Cancer Center,
was one of the first researchers to use chemotherapy combined with the
drug trastuzumab (trade name Herceptin) on women with breast cancer
before – rather than after – surgery.
Five patients in advanced stages of the disease participated in her
original clinical trial, receiving the so-called optimized systemic
treatment. One by one, over a period of several months, their breast
image scans came in, looking like colorful Rorschach tests. Mehta liked
what she saw.
tumors were disappearing before our very eyes,” she recalls. “When we
reviewed the fifth patient’s scans, we realized we had a 100 percent
response rate. That’s when I knew the treatment wasn’t just a fluke.”
who works in hematology/oncology at UC Irvine Medical Center, published
her findings and played a pivotal role in convincing the medical
establishment to routinely administer chemotherapy and trastuzumab
prior to breast cancer surgery.
“I felt like someone from the future. I used this treatment before
it became standard procedure because I knew it saved lives,” she says.
Mehta continues to advance breast cancer research, conducting numerous
clinical trials to improve chemotherapeutic regimens and incorporate
new biological compounds to target tumors.
looking for the characteristics in tumors that make patients respond to
certain drugs,” she says. “The preoperative setting is perfect for
these studies, because in postoperative patients you’ve already removed
the tumor. You’re targeting cells you cannot see. But if there’s a
tumor there in front of you, you can see if a drug works.”
illustrate this, Mehta turns to her computer and calls up a series of
four MRI scans. In the first, the cancer has nearly taken over the
breast; the mass then shrinks as the patient undergoes the chemotherapy
treatment until, in the final image, it’s invisible.
many cases, the tumors disappeared entirely. We had complete responses
[no microscopic evidence of cancer]in four to five months,” she says.
“Patients would have surgery, and doctors couldn’t find the tumors
because they were gone. Many who would have had a mastectomy were able
to have a lumpectomy instead.”
Mehta recently presented data at the annual meeting of the
American Society of Clinical Oncology
showing that, since her first clinical trial in 2003, patients
with stage II and III breast cancer experienced the highest complete response
rates ever reported.
In her small
of about 50 patients, women with stage II breast cancer had a 100
percent survival rate – compared to the historical rate of 86 percent.
Those with stage III breast cancer had a 94 percent survival rate –
compared to the historical rate of 57 percent.
In 2004, Irvine resident Christine Ortega discovered a rash on her left
breast. The rash, it turned out, was caused by inflammatory breast
cancer, a rare and aggressive form of the disease. Mehta became her
primary oncologist at the UC Irvine Breast Health Center
and asked if she’d participate in a clinical trial.
figured, ‘What do I have to lose?'” Ortega says. In fact, she had
everything to gain. Administered before surgery, the
chemotherapy/trastuzumab made her 8-centimeter tumor disappear
completely on an MRI scan. When she later had a mastectomy as a
precautionary treatment to remove any stray cancer cells, none were
detected. Now 56, Ortega has been in remission for more than five years.
Mehta is amazing. The treatment was a huge success,” she says. “I
credit her as one of the people at the Breast Health Center who saved
came to UCI in 1992 for fellowship training in hematology/oncology
after earning a medical degree from Mahatma Gandhi Memorial Medical
College in her native India.
Since then, she’s been principal investigator on many clinical trials. She recently studied patients with
triple-negative breast cancer,
a particularly virulent form of the disease that lacks the three receptors targeted by the most successful treatments.
Mehta put these women on an accelerated schedule of preoperative
chemotherapy treatment — with doses biweekly or weekly instead of every
three weeks. Her results, published as a letter in the Journal of Clinical Oncology,
showed a survival rate of 93 percent, compared to the historical rate of 74 percent.
She also belongs to a UCI research team investigating a new
handheld laser scanner
for detecting and diagnosing breast cancer. Mehta has started using it
to evaluate patient response to chemotherapy before surgery. Someday,
she speculates, the device could become common practice.
It wouldn’t be the first time she’s led the way in the fight against breast cancer.