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Chi-Chen Hong, PhD
Department of Cancer Prevention and Control
Roswell Park Cancer Institute
Buffalo, New York
- Seeking answers to why some women develop aggressive breast cancers called triple negative.
- Studies are ongoing to understand the racial disparities in triple negative breast cancer incidence and outcome.
- These studies are advancing our understanding of disparities in breast cancer outcome and will provide a framework for future studies.
Triple negative breast cancer (TNBC) is an aggressive disease that disproportionately affects women of African ancestry. Understanding the biological factors that underlie this disparity will enable the development of better treatments and prevention strategies. Drs. Hong and Ambrosone have identified several factors including breast feeding and host immune factors that may influence the incidence of TNBC in black women.
Full Research Summary
Triple negative breast cancer (TNBC) is an aggressive disease. While it accounts for less than 20 percent of breast cancer diagnosed in the U.S., women of African American descent are two times more likely to be diagnosed with TNBC than white women.
Drs. Hong and Ambrosone are interested in understanding the underlying biology of this disparity. In ongoing studies, they have shown that levels of a gene called FOXA1 that is important in preventing development of ER-negative tumor were lower in ER-negative breast cancers in women who did breastfeed after childbirth. To determine if this pattern of FOXA1 expression reflects reproductive events prior to development of cancer, the research team will compare FOXA1 levels in breast cancer patients and in women without cancer.
In other work Drs. Hong and Ambrosone are studying how the immune system may influence the risk of TNBC. In the past year, they showed that there are differences in circulating levels of some immune factors and in genes that regulate immune response according to breast cancer subtypes. These differences were also seen between American women of European (EA) and African (AA) ancestry.
High levels of immune cells called tumor infiltrating lymphocytes (TILs) in TNBC is usually a sign of better prognosis. In spite of this trend, the researchers noted higher TILs but worse prognosis TNBC tumors from AA women compared to white women. When they looked deeper in the tumors from black women they found that the majority of TILs were dysfunctional and thus not effective in tumor cell killing.
In the coming year, they will examine types of immune cells in relation to survival, which may inform more effective immunotherapies for women with aggressive breast cancer.
Identifying immune subsets and ratios that differ by race and subtypes will be crucial for future studies of the role of immune factors in disparities in treatment outcomes and may provide critical information for future studies of immunotherapy, particularly for women with ER negative breast cancer.
Dr. Chi-Chen Hong is an Associate Member in the Department of Cancer Prevention and Control within the Division of Cancer Prevention and Population Sciences at Roswell Park. Dr. Hong's research is focused on breast cancer etiology, survivorship, and prognosis. Specifically, her interests are on the influence of lifestyle, comorbidity, genetics, and immune factors. She has an ongoing prospective cohort study of early stage breast cancer patients to examine issues in breast cancer survivorship, and with colleagues at the Rutgers Cancer Institute of New Jersey and Rutgers University is principal investigator of a study examining the role of obesity and related comorbidities, including asthma and type 2 diabetes, and their management on quality-of-life and breast cancer survival outcomes among African American women, and to elucidate key pathways mediating these associations.