Carol J. Fabian, MD
Kansas City, Kansas
Professor of Internal Medicine
Director, Breast Cancer Prevention and Survivorship Centers
Morris Family Endowed Chair in Cancer Prevention
University of Kansas Medical Center
Kansas City, Kansas
To develop strategies to prevent breast cancer in moderate- to high-risk women and to improve health and quality of life for breast cancer survivors.
Chemoprevention drugs such as tamoxifen or aromatase inhibitors dramatically reduce the risk of developing breast cancer, but many women will discontinue their use due to side effects that can initiate or worsen menopausal symptoms. Hormone replacement therapy (HRT) is the most effective way to reduce the vasomotor symptoms of menopause (hot flashes, flushing and night sweats), but there is concern that HRT might increase the risk of developing breast cancer, particularly in women with a higher than average risk. Duavee® (a combination of conjugated estrogen and bazedoxifene), is FDA approved for relief of hot flashes and prevention of osteoporosis. In her BCRF studies, Dr. Fabian has shown that women who took Duavee® had a reduction in breast density and breast tissue proliferation (cell growth) as well as a reduction in blood progesterone, testosterone, and IGF-1 levels—factors all known to promote breast cancer growth. These observations suggest that Duavee® might be helpful for breast cancer prevention. Therefore, Dr. Fabian is investigating the potential use of Duavee® as a safe alternative to current hormone-based chemoprevention in women at risk of breast cancer.
Based on the results of preclinical studies, Dr. Fabian and her colleagues have launched a multi-institution Phase II NCI-sponsored randomized clinical trial of Duavee® versus placebo to assess its effects on risk-associated biomarkers.
She and her team will continue their investigations of Duavee® and its potential use as a chemo-preventive. Building on the results from the Duavee® trial, Dr. Fabian will investigate similar combination approaches for primary breast cancer chemoprevention—those attractive potential candidates that may alleviate vasomotor symptoms as well as reduce risk.
Carol Fabian received her MD, internal medicine and oncology training from the University of Kansas School of Medicine in Kansas City, Kansas. Dr. Fabian joined the faculty at the University of Kansas Medical Center in 1977 and currently holds the rank of Professor. She serves as the Director of the Breast Cancer Prevention and Survivorship Centers. These centers are heavily involved in translational research in addition to providing clinical services. She leads the Cancer Prevention Research Program within the University of Kansas Cancer Center and holds the Morris Family Endowed Chair in Cancer Prevention.
Dr. Fabian pioneered the use of random periareolar fine needle aspiration to acquire breast epithelial cells for refinement of breast cancer risk assessment. The technique is also used for evaluation of biomarkers to monitor response in early phase breast cancer prevention clinical trials: 1) weight loss in combination with omega-3 fatty acid supplementation; 2) a flaxseed lignin derivative; and 3) an aromatase inhibitor in postmenopausal women taking hormone replacement. She is also involved in clinical studies to promote health and quality of life for breast cancer survivors and serves as a Co-Chair for the Cancer Survivorship Committee of SWOG.
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