Titles and Affiliations

John Snow Professor of Epidemiology
Director, Wolfson Institute of Preventive Medicine
Head, Centre for Cancer Prevention

Research area

Improving risk and prognostic assessments for breast cancer.

Impact

Analysis of biobanked samples—blood, tissue, and clinical data from consenting patients—is a critical component of all cancer research. Mountains of data can be gleaned from these samples, whether it’s looking for patterns that can predict breast cancer risk or maximizing the amount of information gathered from a clinical trial. The IBIS Prevention trials, led by Dr. Cuzick and retired colleague Dr. John Forbes, began in 1992 and continue to be the definitive studies on the use of tamoxifen and anastrozole in patients with a high risk of developing breast cancer. Today, Drs. Cuzick and Francis’ studies help guide the most appropriate screening and preventative strategies for individuals based on better estimates of their breast cancer risk.  

Progress Thus Far

Prevention research is a long-term game because it takes many years of follow-up to get a clear picture of the value of preventive therapy. The High-Risk Breast Cancer Biobank (HRBCBB) was established as a repository for specimens from the IBIS trials to better understand who is at high risk of breast cancer, who will respond to treatment, and who is most likely to experience treatment-related side effects. Using the material collected in the HRBCBB, the team carried out the first biomarker studies in a ductal carcinoma in situ (DCIS) randomized trial evaluating the prognostic role of the breast cancer genes estrogen receptor (ER) and HER2. They confirmed the prognostic role of ER and HER2 in DCIS—i.e., they are markers that can help stratify patients as either high or low risk of recurrence. Furthermore, they found that HER2 also predicted radiotherapy benefit, thereby helping in treatment decisions. 

What’s next

Ongoing analyses by the team include studying the IBIS-II prevention trial to see if a patient’s natural hormone levels affect the performance of preventative therapies in high-risk individuals. They also are examining the role of mutations for more than 100 genes in cancer tissues in the TransATAC cohort. In addition, the team will collaborate with researchers around the world to collect data from several ongoing therapeutic trials. The EXPERT clinical trial is a radiation oncology “equivalent” of the TAILORx trial—utilizing a multigene assay to see if radiation therapy can be safely de-escalated in the context of adjuvant endocrine therapy. Correlative studies using  biobanked clinical samples from immunotherapy trials such as DIAmOND, and Neo-N, led by BCRF investigator Sherene Loi, provide opportunities to tailor immunotherapy to those patients most likely to benefit.  

Biography

Jack Cuzick, PhD is Director of the Wolfson Institute of Preventive Medicine in London. He is also head of the Centre for Cancer Prevention and John Snow Professor of Epidemiology at Queen Mary, University of London. He holds a PhD in Mathematics and has previously worked at Oxford University and Columbia University, New York.

His current interests are in cancer epidemiology and clinical trials, with special interest in prevention and screening. He is currently Chairman of the International Breast Cancer Intervention Study (IBIS) Steering Group and the ATAC trial. He has worked extensively in breast cancer and was the first to report the effect of tamoxifen on contralateral tumors as an indicator of its potential chemopreventive role and also has demonstrated that a change in mammographic breast density on endocrine treatment is a biomarker for its effectiveness. He is involved in studies on the use of HPV assays for cervical screening, the use of flexible sigmoidoscopy for colorectal cancer screening and markers for the behavior of early prostate cancer.

Dr. Cuzick is a Fellow of the Academy of Medical Sciences, the Royal Statistical Society, the Institute of Mathematical Statistics, the Royal Society, and an Honorary Fellow of the Royal College of Physicians and was awarded a CBE by the Queen in 2017. In 2007, he was chosen by Thompson Scientific as one of the twelve hottest researchers in all of science and this has been re-awarded for several years thereafter. He was awarded the AACR Cancer Prevention Prize in 2012. He is the author of more than 650 peer-reviewed papers and has published in all the major medical journals

BCRF Investigator Since

2011

Donor Recognition

The Delta Air Lines Award

Areas of Focus

Co-Investigator