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Jack Cuzick, PhD, FRS, CBE
John Snow Professor of Epidemiology
Centre for Cancer Prevention
Queen Mary University of London
London, United Kingdom
Goal: To identify protein and gene biomarkers that will improve risk assessment in women at high risk of developing breast cancer.
Impact: Drs. Cuzick and Francis are expanding their high-risk breast cancer biobank, which is a collection of blood and tissue samples, mammograms, and clinical data from women enrolled in breast cancer prevention and treatment trials. This resource will help them determine which types of breast cancer will respond to different kinds of preventive treatment.
What’s next: The team will collaborate with researchers around the world to collect samples and data from women taking part in several ongoing trials.
While large randomized clinical trials may provide clues for predicting response to therapy or late recurrence, the results don’t apply to every participant because individual responses are influenced by the patient’s and the tumor’s unique genetic profile. By gathering samples and data from women enrolled in clinical trials, Drs. Cuzick and Francis hope to identify biomarkers that will help them understand why some patients respond to therapy and others do not, and to identify patients at high risk of recurrence.
Full Research Summary
Research area: Seeking to improve breast cancer risk assessment in high-risk women by identifying protein and gene biomarkers.
Impact: 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. This includes not only information on efficacy and side-effects, but also identifying biomarkers for predicting risk and response to treatment. The IBIS Prevention trials led by Dr. Cuzick continue to be the definitive studies on the preventive use of tamoxifen and the aromatase inhibitor anastrozole in women with a high risk of developing breast cancer. The High-Risk Breast Biobank (HRBCBB) was established as a repository for specimens from the IBIS trials with the goal to better understand who is at high risk of breast cancer, who will respond to endocrine (anti-estrogen) treatment—with a special interest in differential response to tamoxifen or aromatase inhibitor (anastrozole for these trials), and who is most likely to experience treatment-related side effects.
Current investigation: The team is expanding their High-Risk Breast Cancer Biobank (HRBCBB), which includes blood, tumor tissue, and mammograms, as well as clinical outcome data and long-term follow-up of individual women in prevention and treatment trials.
What they’ve learned so far: In the last year, Drs. Cuzick and Francis published results from IBIS II, a randomized, double-blind trial investigating the benefit of long-term anastrozole for the prevention of breast cancer in high-risk women. With a median follow up of five years, anastrozole significantly reduced breast cancer incidence, both invasive ductal carcinoma and ductal carcinoma in situ. These results were published in the journal, Lancet. They continue to follow patients to determine the impact of anastrozole on mortality.
What’s next: As new trials such as EXPERT, CHARIOT and DIAmOND are conducted and a new cohort study PRIMROSE is set up, biospecimens from participants in these investigations will be collected and added to the HRBCBB, further expanding this resource for future translational research.
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