Titles and Affiliations
Director, Central Nervous System Metastasis Program
Professor of Medicine
Harvard Medical School
Massachusetts General Hospital
Boston, Massachusetts
Research area
Identifying new strategies for the prevention and treatment of breast cancer that has spread to the brain.
Impact
Breast cancer that spreads to the brain occurs in more than a third of patients with advanced breast cancer. While advances in cancer therapies have improved our ability to control breast cancer outside of the brain, more breast cancer patients are dying of brain metastases. The genetic and molecular drivers of metastasis are largely unknown. The overarching objective of Dr. Brastianos’ work is to characterize the tumor and immune microenvironment of brain metastases that will shed light on their fundamental biology and to ultimately identify novel therapeutic targets. Dr. Brastianos hopes to quickly translate her team’s scientific findings to innovative clinical trials for patients with breast cancer brain metastases.
Progress Thus Far
Over the past year, Dr. Brastianos and her team made significant progress in their efforts to understand and ultimately improve treatment for patients with breast cancer that has spread to the brain. The team continued to expand a large, international collaborative network to collect and study tumor samples. This effort has resulted in one of the most extensive collections of breast cancer brain metastasis samples in the world, supported by partnerships across institutions in North America, Europe, Asia, and Australia. Using this resource, they are comprehensively analyzing a large number of tumor and blood samples using advanced single-cell technologies. This analysis revealed that these tumors rely on known cancer pathways to drive their growth and survival, and importantly, the team identified a less well-studied pathway that may represent a promising new therapeutic target. The team also found that tumor cells may adopt features of brain cells themselves, which may help explain how these cancer cells adapt to and thrive within the brain’s unique environment. Finally, Dr. Brastianos’ team completed enrollment in a clinical trial testing targeted therapies based on the genetic features of a patient’s tumor, translating the team’s laboratory findings into a treatment option now being tested in patients.
What’s next
In the coming year, Dr. Brastianos will continue efforts to understand how breast cancer cells are able to survive and grow after spreading to the brain. She and her team will continue to analyze their expanded dataset using integrated approaches that combine genomic, transcriptomic, and spatial profiling, correlating these findings with patient outcomes to identify actionable therapeutic targets. To support this effort, Dr. Brastianos is piloting a new platform called 10X Visium, which allows gene expression mapping across tumor tissues while preserving information about where cells are located. This will help them better understand how cancer cells interact with immune cells inside brain metastases and how those interactions may influence how tumors respond to therapy. The team will validate these findings using complementary imaging approaches, bringing together their genetic discoveries with a deeper understanding of how tumor cells interact with the brain environment.
Biography
Dr. Priscilla Brastianos is the Director of the Central Nervous System Metastasis Program at Massachusetts General Hospital of Harvard Medical School. Originally from Vancouver, British Columbia, she received her BSc in biochemistry and chemistry from the University of British Columbia, where she graduated as her class valedictorian. She completed her medical school training at Johns Hopkins School of Medicine, and her internal medicine residency training at Johns Hopkins Hospital. Following her training at Johns Hopkins, she pursued her fellowship training at the Dana-Farber Cancer Institute and Massachusetts General Hospital. As a physician-scientist, Dr. Brastianos received a number of prestigious awards for her scholarship and research.
Dr. Brastianos’ research focuses on understanding the molecular mechanisms that drive brain metastases. Her pioneering work has led to national multicenter cooperative group trials that she is leading. She also leads a multidisciplinary central nervous system metastasis clinic at Massachusetts General Hospital. Her hope is that the findings from genomic studies will provide an understanding of the molecular pathways that drive brain metastasis, which will allow the development of more rational therapeutic approaches for this common and devastating complication of cancer.
