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Eric P. Winer, MD
Professor of Medicine, Harvard Medical School
Chief, Division of Women's Cancers
Director, Breast Oncology Center
Dana-Farber Cancer Institute
Seeking strategies to prevent and treat breast cancers metastasis to the brain and to unravel the mechanisms leading to drug resistance in metastatic breast cancer.
Laboratory and clinical studies are employed in the development and testing of new therapies and combination approaches to prevent metastasis and improve response to targeted therapies.
These studies are advancing the clinical evaluation of much needed systemic treatment options for patient with breast cancer brain metastasis.
Despite the high frequency of brain metastases, especially in patients with advanced HER2-positive or triple-negative breast cancer, there are currently no FDA-approved systemic treatments for this problem. The standard of care for brain metastasis, as it has been for many decades, is radiation therapy (and surgery in select patients).
Systemic treatments hold the promise of treating tumors in both the brain and body, and potentially delaying or even preventing brain metastases from occurring. The team of Drs. Winer, Lin and Zhao is leading a multi-pronged effort to evaluate new systemic approaches in patients with brain metastases from breast cancer, including the development of laboratory models to test promising treatments, followed by translation into clinical trials.
Several agents, including tucatinib and neratinib, have demonstrated encouraging preliminary evidence of activity, with studies ongoing and/or planned to follow up on these observations. This year, new combinations will be tested in the clinic, including further exploration of CDK4/6 inhibitors and immunotherapy-based approaches.
Overall, the team's work represents the largest broad-based effort to evaluate new systemic options in patients with brain metastases from breast cancer.
Drs. Winer and Lin continue to expand the EMBRACE research study. Over 1,700 patients have been enrolled and in collaboration with the Broad Institute, a subset of patients will have detailed analysis of circulating tumor DNA in blood, as well as analysis of tumor tissue. These efforts will provide clues to drug resistance.
The hope is that by developing a better understanding of resistance mechanisms, they can identify and prioritize the pathways that are most critical in developing the next generation of treatment strategies.
Eric P. Winer, MD, is Professor of Medicine at Harvard Medical School and Chief, Division of Women's Cancers and the Thompson Senior Investigator in Breast Cancer Research at Dana-Farber Cancer Institute. He is also Co-Chair of the Breast Committee of the Alliance for Clinical Trials. Dr. Winer has devoted his professional career to the treatment of individuals with breast cancer and breast cancer research. He has designed and led phase I, II, and III clinical trials. Dr. Winer has collaborated closely throughout his career with psychosocial, health services, basic, and translational researchers. He is the Principal Investigator of the Dana-Farber/Harvard Cancer Center SPORE in Breast Cancer.
Dr. Winer is a graduate of Yale College, with a degree in History and Russian/East European Studies. He subsequently obtained his medical degree from Yale School of Medicine, followed by training in internal medicine at Yale. He completed a fellowship in medical oncology at Duke University Medical Center and remained on the Duke Faculty until 1997, when we moved to Dana-Farber Cancer Institute in Boston to assume the role of Director of the Breast Oncology Center.