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Eric P. Winer, MD
Professor, Medicine, Harvard Medical School
Director, Breast Oncology Center, Dana-Farber Cancer Institute
Physician Active Staff, Medicine, Brigham And Women's Hospital
Dana-Farber Cancer Institute
Member, BCRF Scientific Advisory Board
Goal: To improve quality of life for patients with HER2-positive breast cancer.
Impact: Dr. Winer is conducting studies aimed at identifying patient with HER2-positive breast cancer who may forego post-surgery chemotherapy. His work could spare many from unnecessary treatment and the associated side effects and costs.
What’s next: He and his team will launch a small trial investigating the level of comfort from patients with a very good prognosis and their doctors to treatment with HER2-targeted therapies and no added chemotherapy.
More than 90 percent of patients with early-stage HER2-positive breast cancer are cured with modern treatment regimens. However, many receive more treatment than they need, which exposes them toxic therapies and adds to their financial burden. Dr. Winer is pursuing ways to determine whether certain patients who, prior to surgery, have all their cancer eradicated from their breast and lymph nodes, can be treated with HER2-targeted drugs alone without any additional chemotherapy.
Full Research Summary
Research area: Advancing precision medicine with strategies that will deliver the right drug to patients with HER2-positive breast cancer.
Impact: Once an aggressive and lethal disease, HER2-positive breast cancer is often curable with modern medicines that target the HER2 protein. Some patients, however, will need more aggressive therapies including chemotherapy and multiple HER2-targeted agents. These options can reduce the risk of recurrence in patients with aggressive disease, but they come with added medical and financial toxicities. Under current “one-size-fits-all” treatment strategies that exist in many clinics, all HER2-positive patients receive two additional chemotherapy drugs after surgery even though the benefit of more chemotherapy is uncertain. Dr. Winer is conducting a pilot study to determine whether patients and their doctors would accept/prescribe less intensive chemotherapy when the patient has an excellent prognosis. The ultimate goal is to change standard-of-care so that treatment matches the prognosis and patients with less aggressive disease are spared the toxicities and expense of additional chemotherapy.
Current research: Dr. Winer and his team are conducting a clinical trial in patients with stages II and III HER2-positive breast cancer who have excellent response to their preoperative treatment. They will assess both attitudes and the willingness of patients and doctors to adhere to a reduced chemotherapy regimen after surgery.
What he’s learned so far: He and his team opened recruitment to the DAPHNe trial (De-escalation to adjuvant antibodies post-pCR to neoadjuvant THP (paclitaxel/trastuzumab/pertuzumab)--a pilot study in HER2-positive breast cancer. The promising rate of accrual across multiple Massachusetts locations suggests excitement about developing a tailored approach to care for patients with stage II and III HER2-positive breast cancer.
What’s next: Dr. Winer will expand this clinical trial into a larger national trial with the overall goal of developing treatments for HER2-positive breast cancer that are highly effective but also minimize side effects for a subgroup of patients with excellent prognosis.
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.