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Joseph A. Sparano, MD
Professor at Albert Einstein College of Medicine
Vice-Chair, ECOG-ACRIN Cancer Research Group
Goal: To improve treatment outcomes and reduce the risk of breast cancer recurrence by identifying biomarkers to inform treatment decisions, as well as to advance the understanding of invasive lobular carcinomas (ILC).
Impact: Dr. Sparano is leading studies to identify and validate markers from patient tissue and blood to improve personalized treatment approaches and outcomes for breast cancer patients. He and his team are analyzing ILC tumor samples in order to gain much-needed insight into this understudied form of breast cancer.
What’s next: In addition to continuing his current studies, Dr. Sparano and his team will analyze tumor samples obtained from patients who experienced a late relapse (5 or more years after treatment) of breast cancer to evaluate biomarkers that can help identify patients with early-stage breast cancer who are at risk of recurrence.
Blood and tissue samples from breast cancer patients who take part in clinical trials are a valuable resource for researchers. They reveal details about the nature of the disease and can also be used to discover biomarkers that help inform personalize treatments and reduce side effects. This year, Dr. Sparano will continue to retrieve and process tumor samples that have been collected in the course of clinical trials. Part of these studies will focus specifically on invasive lobular cancer (ILC) to better understand treatment response in patients with this common but understudied form of breast cancer
Full Research Summary
Research area: To identify prognostic and predictive biomarkers to personalize clinical decision-making and improve treatment outcomes as well as gain a better understanding of invasive lobular cancer and the determinants of late relapses of breast cancer.
Impact: Working under the auspices of the Coalition of Cancer Cooperative Groups and ECOG-ACRIN Breast Committee, BCRF investigator, Dr. Joseph Sparano is leading efforts to advance the clinical management of breast cancer by utilizing resources collected as part of ongoing clinical trials to identify biomarkers that can better inform treatment decisions. Part of his ongoing work is the characterization and evaluation of lobular cancer in ECOG-ACRIN Phase III breast cancer trials. Lobular breast cancer is the second most prevalent type of the disease, arising in the milk-producing glands of the breast. Dr. Sparano’s research in lobular cancer is essential to understand the many subtypes of breast cancer. He hopes these studies will improve our understanding of the development, prognosis, and treatment of breast cancer.
Current investigation: Dr. Sparano will oversee ongoing efforts in the analysis of samples from the Late-Relapse Repository and ongoing ECON-ACRIN trials. Specifically, samples from ongoing trials will be analyzed to examine biomarkers of a painful side effect that affects compliance with anti-estrogen therapy in some women; predict benefit from a novel combination treatment for ER-positive breast cancer; and indicate which patients benefit from additional chemotherapy. They will also continue the initiative which focuses on the characterization and evaluation of lobular cancer in ECOG-ACRIN Phase III breast cancer trials.
What he’s learned so far: Results from the ECON-ACRIN trials has shown that there are genetic markers that may indicate a patient is at higher risk of neuropathy when treated with chemotherapy. In addition, a recent discovery from the TAILORx trial validated a gene-based test to predict which patients can safely forego chemotherapy after hormone treatment for breast cancer. From another ECOG-ACRIN study, Dr. Sparano and his colleagues determined that the presence of circulating tumor cells (CTCs) – tumor cells that have escaped the tumor and entered the circulation – in the blood of patients with early-stage breast cancer was associated with an 18.3 percent increased risk of breast cancer recurrence.
What’s next: Efforts in the next year will include analyzing data from several ECOG-ACRIN breast cancer treatment trials including studies in patients with metastatic and triple negative breast cancers, assessing the best mammographic screening modality for healthy women, and identifying patients at risk aromatase inhibitor-induced musculoskeletal symptoms. Using samples from the Coalition of Cancer Cooperative Groups Late Relapse Repository, they will evaluate inflammatory biomarkers in serum from patients and determine the feasibility of analyzing cell free DNA from plasma samples.
Joseph Sparano is Professor of Medicine & Women's Health at the Albert Einstein College of Medicine, Associate Chairman for Clinical Research in the Department of Oncology at Montefiore Medical Center, and Associate Director for Clinical Research at the Albert Einstein Cancer Center. He also serves as Vice Chair of ECOG-ACRIN and Vice-Chairman of the AIDS Malignancy Consortium. Dr. Sparano's research has focused on developmental therapeutic approaches for breast cancer, lymphoma, and HIV-associated cancers, and therapeutic applications of genomic profiling in cancer. He is the chair of the TAILORx clinical trial in breast cancer, an NCI-sponsored trial designed that is integrating multi-parameter gene expression profiling in clinical practice (http://www.cancer.gov/clinicaltrials/noteworthy-trials/tailorx).