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Carlos L. Arteaga, MD
Professor of Medicine
Director Simmons Cancer Center
University of Texas, Southwestern Medical Center
- Seeking to understand drug resistance and to develop new approaches to improve clinical outcomes.
- A clinical trial is underway to test a targeted combination approach in women with ER-positive breast cancer.
- These studies have important clinical implications for patients with ER-positive breast cancer that have stopped responding to anti-estrogen therapies.
Estrogen is the key driver of most breast cancers. Anti-estrogen drugs, such as tamoxifen or aromatase inhibitors, are effective treatments for these cancers. Many estrogen-driven breast cancers, however will become resistant to the therapy. Dr. Arteaga is conducting studies to look for tumor markers of drug resistance and is devising more effective therapeutic approaches for patients less likely to respond to anti-estrogen therapy.
Full Research Summary
Most estrogen receptor (ER)-positive breast cancers depend on female hormones and initially respond to anti-estrogen (endocrine) therapies, such as tamoxifen, aromatase inhibitors, and fulvestrant. However, many of these cancers eventually become resistant to ER-targeted therapies.
Dr. Arteaga's BCRF research is focused on understanding why ER-positive tumors become resistant and developing new approaches to improve clinical outcomes. His group has completed a clinical trial in which women with ER-positive breast cancer received the aromatase inhibitor letrozole for 10-21 days prior to surgery (neoadjuvant therapy).
Using a molecular marker of cell growth called Ki67, they can distinguish between tumors that are responsive to the therapy (low Ki67) versus those that continue to grow (high Ki67). Coupling these data with genetic profiling, they identified a gene called FGFR1 as a potential therapeutic target to prevent endocrine resistance.
Parallel to these studies, they are conducting clinical trials with FGFR1 inhibitors in patients with breast cancers that have high levels of FGFR1. Early results are promising, and they are now initiating studies to combine letrozole with FGFR1 inhibitors and/or CDK4/6 inhibitors in patients with this type of tumor. These studies have important clinical implications for patients with ER-positive breast cancer.
Dr. Arteaga is Professor of Medicine and Director of the Simmons Cancer Center at University of Texas, Southwestern Medical Center. He was formally Associate Director for Clinical Research, Director of the Breast Cancer Program, and Director of the Center for Cancer Targeted Therapies at the Vanderbilt-Ingram Cancer Center, where he also held the Donna S. Hall Chair in Breast Cancer Research and Professor of Medicine and Cancer Biology. Dr. Arteaga trained in Internal Medicine and Medical Oncology at Emory University and the UT Health Sciences Center San Antonio, respectively. He has over 250 publications in the areas of signaling by growth factor receptors and oncogenes, targeted therapies and biomarkers of drug resistance, and investigator-initiated clinical trials in breast cancer. Since 2002, he has directed the NCI-funded Vanderbilt Breast SPORE. He is a member of the ASCI and the Association of American Physicians. He received the AACR Richard & Hinda Rosenthal Award, a 2007-2017 ACS Clinical Research Professor Award, the 2009 Gianni Bonadonna Award from ASCO and the 2011 Brinker Award from the Susan G. Komen Foundation. He has served as AACR co-chair of the annual San Antonio Breast Cancer Symposium since 2009. He is Deputy Editor of Clinical Cancer Research and member of the Editorial Board of Cancer Cell and six other peer-reviewed journals. He is immediate past President of the AACR in 2015.