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Elizabeth Comen, MD
Assistant Attending Physician
Breast Medicine Service
Memorial Sloan Kettering Cancer Center
New York, New York
Goal: To develop a blood-based test that can identify breast cancer patients whose disease may spread to other sites in the body (metastasize).
Impact: Drs. Comen and Tavazoie are studying molecules called microRNAs that are released into the blood by cancer cells and could be used to detect and classify breast cancer. Their work could help predict which patients are at risk of metastasis and also identify those who may respond well to chemotherapy and targeted anti-cancer drugs.
What’s next: The team has discovered that measuring certain microRNAs in blood can identify which patients have metastatic breast cancer (MBC) and which do not, as well as distinguish between those with breast cancer versus benign disease. They will now add more patients to their study in order to confirm these findings.
Tumors release many factors into the blood that could be used to monitor the progression of breast cancer. These include microRNAs that, depending on the genes they act on, can stimulate or suppress tumor formation and growth. Drs. Comen and Tavazoie aim to discover specific microRNAs in the blood of breast cancer patients and learn the role they play in the progression of the disease, as well as develop biomarkers that could aid diagnosis and guide treatment decision-making.
Full Research Summary
Research area: Studying the blood of cancer patients to identify new predictive markers to aid in the clinical management of breast cancer.
Impact: Recent work has revealed that cancer cells have the remarkable capacity to communicate with other cells by releasing structures called exosomes into circulation. These exosomes contain RNAs including a class of small-RNAs called microRNAs, which can modulate the expression of many genes involved in tumor growth. Drs. Comen and Tavazoie are conducting studies to harness the information contained in circulating microRNAs in innovative ways to improve the clinical management of breast cancer.
Current research: Drs. Comen and Tavazoie aim to discover specific microRNAs that are present in the circulation of breast cancer patients, to use these circulating microRNAs as molecular probes to study how they drive breast cancer progression, and to develop them into biomarkers for the detection and classification of breast cancer.
What they’ve learned so far: Based on the types of microRNAs isolated from blood from 109 breast cancer patients or patients with benign breast diseases, they were able to distinguish blood from breast cancer patients from patients with benign breast diseases, and blood from metastatic breast cancer patients from those with early-stage breast cancer at an accuracy of 85 percent and 92 percent, respectively.
What’s next: In the coming year, they will recruit an additional cohort of 100 age-, ethnicity- and subtype-matched women to validate the diagnostic and prognostic value of circulating microRNAs. They will extend their analysis to other types of small-RNAs such as tRNA fragments. The proposed work has important potential for clinical impact and could provide novel insights into this largely unexplored area of circulating small-RNAs in cancer.
Dr. Elizabeth Comen is a medical oncologist at Memorial Sloan Kettering Cancer Center with a practice devoted to the study and treatment of patients with all stages of breast cancer. Dr. Comen earned her BA from Harvard College and her MD from Harvard Medical School. She completed residency at Mount Sinai Hospital and her fellowship at Memorial Sloan Kettering Cancer Center. She has presented her research many times at the American Society of Clinical Oncology (ASCO) Annual Meeting and the San Antonio Breast Cancer Symposium. She has also been awarded several peer-reviewed grants, including the Young Investigator Award from the Conquer Cancer Foundation of ASCO.
Dr. Comen’s research focuses on the mechanisms by which breast cancer metastasizes and spreads to distant organs. In particular, she collaborates with several laboratories to help translate laboratory discoveries regarding metastasis into clinically meaningful treatments for patients at risk for and with metastatic breast cancer. With her laboratory collaborators, Dr. Comen aims to identify unique biomarkers that can help identify new diagnosis of breast cancer as well as identify those women with early-stage breast cancer who are at increased risk for metastasis. For patients with metastasis, the team is using laboratory methods understanding of metastasis to develop more effective and less toxic treatments.