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Hope S. Rugo, MD, FASCO
Director, Breast Oncology and Clinical Trials
UCSF Helen Diller Family Comprehensive Cancer Center
Professor of Medicine
University of California
San Francisco, California
Goal: To develop new, more effective therapies for triple negative breast cancer (TNBC), an aggressive form of the disease.
Impact: Dr. Rugo is pursuing ways to improve response to immunotherapy in patients with TNBC. Her work could lead to more effective combination approaches for treating a subtype of breast cancer that currently has few targeted treatment options.
What’s next: She and her team will investigate the MYC gene, which may play a role in preventing immune cells from killing tumor cells. They will also determine whether analyzing circulating tumor DNA (ctDNA) in the blood can be used to predict metastatic relapse in those who have estrogen receptor (ER)-positive breast cancer.
While immunotherapy has benefitted many patients with various types of cancer, it has been considerably less successful in treating those who have breast cancer. Triple negative breast cancer (TNBC) responds somewhat better to immunotherapy compared to other subtypes of the disease, but most patients still do not benefit from it. Dr. Rugo is studying how TNBC cells are able to avoid attack by the immune system so that new and better immunotherapies can be developed.
Full Research Summary
Research area: Developing new treatment options for patients with triple negative breast cancers.
Impact: Triple negative breast cancer (TNBC) is an especially aggressive subtype of breast cancer. Treating TNBC remains a major challenge due to the limited number of effective drugs. Immunotherapies called checkpoint inhibitors have been effective against some advanced TNBC, but most patients have not received benefit from current immunotherapy approaches. Dr. Rugo is studying ways to improve response to immunotherapy by targeting pathways regulated by the MYC cancer gene.
In a separate study, Dr. Rugo is evaluating the use of liquid biopsy for the early detection of drug resistance and disease progression in patients with hormone receptor-positive, early stage breast cancer with a high risk for recurrence. The results of these studies will help to predict early risk of recurrence, aid in treatment decisions to prevent cancer recurrence, and provide an opportunity to study the mechanisms of resistance.
Current investigation: Dr. Rugo will focus on understanding the role of the MYC cancer gene in protecting the tumor from an immune attack. In a second study, they will utilize serial liquid biopsy to analyze circulating tumor (ct)DNA to determine the efficacy of ctDNA to predict recurrence and to study mechanisms of resistance in patients receiving adjuvant hormone therapy.
What she’s learned so far: Her group has discovered new vulnerabilities in the treatment of TNBCs, which form the foundation of the current study. In addition, they have shown that patients with high numbers of circulating tumor cells (CTCs) have a greater risk of relapse compared to those who have few or no CTCs.
What’s next: Dr. Rugo and her colleagues will continue their studies to develop new ways of improving immunotherapy for patients with TNBC and their work in ctDNA as a predictor of recurrence in women with early-stage, hormone receptor-positive breast cancer.
Hope S. Rugo, MD, is a Professor of Medicine in the Division of Hematology and Oncology at the University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, where she directs Breast Cancer and Clinical Trial Education. Her research interests include novel therapies for advanced breast cancer, immune modulation to restore chemotherapy sensitivity, evaluation of circulating cells as novel markers of response and resistance to therapy, neoadjuvant therapy and supportive care.
Dr. Rugo is a member of the Breast Oncology Program at the UCSF Breast Cancer Center, an investigator in the national multi-center ISPY2 trial, and is the principal investigator of a number of clinical trials. She is one of three recipients of a Komen Promise Award, receives funding from The Breast Cancer Research Foundation, and serves on a number of steering committees for national and international trials. She is a member of the ALLIANCE Breast Core Committee and the Translational Breast Cancer Research Consortium, is the UCSF representative to the NCCN Guidelines Committee, and serves on several committees for the American Society of Clinical Oncology. She has published many peer-reviewed papers and has given presentations on a variety of cancer related topics.
With a summa cum laude degree from Tufts University. Dr. Rugo received her MD from the University of Pennsylvania and completed both a residency in internal medicine and fellowship in hematology and oncology at UCSF, and she completed a postdoctoral fellowship in immunology at Stanford University. She received the Cancer Care physician-of-the-year award in 2010.