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Gad Rennert, MD, PhD
Director, Clalit National Israeli Cancer Control Center
Professor and Chairman,
Department of Community Medicine
Carmel Medical Center
Goal: To understand the natural history of breast cancer in Arab and Israeli women.
Impact: The underlying cause of most breast cancers is as yet unknown. Even in families with a high incidence of breast cancer, inherited mutations in known cancer genes, including BRCA1 and BRCA2, are responsible for only a minority of breast cancers. Dr. Rennert will evaluate gene expression in breast cancer tissue samples to identify immune pathways potentially damaged in young women with breast cancer. This study may help explain the possible origins of early-onset, non-hereditary breast cancer.
What’s next: Dr. Rennert’s team will analyze tumor DNA from breast cancer patients under age 46 with no known mutations in breast cancer risk genes. They will look for gene expression patterns associated with tumor development and progression and correlate these findings with information on lifestyle behaviors and environmental exposures.
Many factors influence breast cancer outcomes and response to treatment. These include ethnicity, age at diagnosis, diet, exercise, biological and genetic characteristics of a patient. Dr. Rennert is leading an international effort aimed at understanding how these factors affect various aspects of breast cancer including risk of recurrence and survival in women in Northern Israel. His current study is aimed at identifying gene expression patterns that may explain this difference and potentially identify early interventions to reduce risk of breast cancer in younger women.
Full Research Summary
Research area: Identifying different patterns of disease progression across diverse populations.
Impact: About a quarter of all breast cancers in the Western population occur in pre-menopausal women. Only about 20 percent of these are explained by single gene mutations in known breast cancer genes. Dr. Rennert believes that the answer to understanding the causes of breast cancer in younger women who do not carry an inherited mutation in a known cancer gene, may be found in the genes of the tumor, rather than germline (inherited) DNA. Specifically, he suspects that tumor mutations in genes that regulates immune response, as well as other small genetic variants in the tumor, will help explain the early onset of breast cancer. Because these genetic changes can be associated with specific behaviors or environmental exposures, his team will also try to correlate them with health habits in young breast cancer patients.
Current investigation: Dr. Rennert and his team will conduct the study in a sample of 1500 women diagnosed with breast cancer before age 46 but with no known cancer gene mutation. The team will conduct genetic analysis on tumor tissue to identify gene expression signatures and collect detailed information regarding lifestyle and environmental exposures.
What he’s accomplished so far: Dr. Rennert and his colleagues have created a database of approximately 10,000 women with breast cancer, one of the world's largest series of breast cancer cases. Having reached a follow up time of 20 years, his findings reveal that in women diagnosed before age 50 (pre-menopausal), those diagnosed with estrogen receptor (ER)-positive breast cancer have better outcomes than those with triple-negative (TNBC) breast cancer.
What’s next: Analysis of the study cohort may help to explain the underlying cause of young-onset breast cancers and potentially reveal associations of some gene expression patterns with behavioral or environmental factors.
Gad Rennert has been chairman of the Carmel Medical Center Department of Community Medicine and Epidemiology since 1992. He is a professor and the head of the public health and epidemiology teaching group at the Technion Faculty of Medicine.
Professor Rennert is also Director of the National Israeli Cancer Control Center and the Department of Epidemiology and Disease Prevention of Clalit and is leading its National Personalized Medicine Program offering testing, advice and policy on individualized molecular testing which dictates cancer risk and suitability for cancer treatments. He is responsible for the national breast and colorectal cancer detection programs in Israel and is a member of the National Oncology Council.
In 1984, Professor Rennert received his medical degree from Ben-Gurion Medical School. He received his PhD in Public Health from the University of North Carolina. He focuses his studies on understanding the behavioral and biological causes of cancer, with special emphasis on gene-environment interactions. He has been an invited speaker in key conferences, such as the Personalized Medicine World Conference, UPCP, American Society of Clinical Oncology, American Association of Cancer Research, St. Galen Cancer Prevention conference and San Antonio Breast Cancer Symposium.
In addition to his activities at the Technion, Dr. Rennert is a reviewer for more than 30 international journals, an associate editor of two and serves on 10 editorial boards. He has published more than 200 papers in leading journals such as the NEJM, Science and Nature.