Titles and Affiliations
Professor of Internal Medicine and Daniel F. Hayes MD Breast Cancer Research Professor
Breast Oncology Disease Lead, Rogel Cancer Center
Interim Chief of the Division of Hematology and Oncology
Research area
Reducing aromatase inhibitor side effects and improving quality of life of breast cancer survivors.
Impact
For patients with estrogen receptor (ER)-positive breast cancer, anti-hormone treatments such as tamoxifen and aromatase inhibitors (AIs) taken for five to ten years after diagnosis reduce the risk of recurrence. However, up to half of patients stop taking these drugs earlier than recommended, primarily because of aggravating side effects. Side effects of aromatase inhibitors include hot flashes, night sweats, and musculoskeletal symptoms such as aches, pains, and stiffness thought to be due, in part, to inflammation. A few treatments for aromatase-induced musculoskeletal symptoms (AIMSS) have been identified, but they only work for a subset of patients. There is a critical need to identify additional effective treatments so that more patients can continue their treatment. Dr. Henry and her team are looking to understand why some patients develop these bothersome side effects and to identify more effective ways to prevent or decrease the side effects of these treatments.
Progress Thus Far
Dr. Henry and her team tested acupressure, a needle-free alternative to acupuncture that patients can do at home at no cost, to see if it could reduce AIMSS symptoms. Unfortunately, acupressure did not perform better than a placebo version of the treatment, with only about half of patients experiencing meaningful pain improvement. Separately, the team’s research into the gut microbiome found that patients with more anti-inflammatory promoting gut bacteria seemed more likely to stay on their aromatase inhibitor and less likely to stop due to joint pain. These results offer a possible clue as to why side effects may vary between patients.
What’s next
Dr. Henry’s team has launched a clinical study testing whether a fiber-like supplement called resistant starch, taken alongside an aromatase inhibitor, can increase levels of the lower-inflammation gut bacteria and reduce joint pain and stiffness. If results are promising, the team plans to develop a larger trial to confirm the findings. The team is also planning a new trial using a GLP-1 agonist, a newer class of weight-loss medication that may also reduce inflammation, to test if it can help lessen AIMSS symptoms. Together, this research aims to deepen understanding of why some patients develop these side effects, so more patients can stay on their anti-cancer therapy while maintaining their quality of life.
Biography
Norah Lynn Henry, MD, PhD, a medical oncologist, is Professor of Internal Medicine and Interim Chief of Hematology/Oncology at the University of Michigan Medical School and the Daniel F. Hayes, MD, Breast Cancer Research Professor at the Rogel Cancer Center. She completed her PhD in Structural Biology at Stanford University School of Medicine, and her medical degree at Washington University in St Louis. She then completed her internal medicine residency at Brigham and Women’s Hospital in Boston, followed by hematology/oncology fellowship training at the University of Michigan.
Dr. Henry was appointed to the faculty at the University of Michigan Medical School in 2007 and since that time has developed expertise in breast cancer management, acute toxicity and late effects of cancer therapy, symptom management, survivorship, and patient-reported outcomes. She has published over 130 peer-reviewed manuscripts and collaborates with colleagues throughout the United States. Dr. Henry has served as national Study Chair for two large randomized clinical trials in SWOG focused on symptom management and persistence with endocrine therapy. Since 2015, she has served as co-chair of the SWOG Symptom Management and Quality of Life committee and served as Scientific Program Chair for the 2021 ASCO Annual Meeting. Dr. Henry serves as primary mentor for numerous medical students, fellows, and early career faculty.
Dr. Henry has received grant funding from the National Cancer Institute, American Cancer Society, Damon Runyon Cancer Research Foundation, V Foundation, American Society of Clinical Oncology, Expedition Inspiration, the University of Michigan Rogel Cancer Center, and the Breast Cancer Research Foundation.
