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Joseph A. Sparano, MD
Professor at Albert Einstein College of Medicine
Vice-Chair, ECOG-ACRIN Cancer Research Group
- Seeking to advance treatment and improve outcomes by conducting practice-changing clinical trials and identify biomarkers of response.
- Ongoing clinical trials are focused on side effects from aromatase therapy and new immunotherapies. Biospecimens are collected to better understand breast cancer and response to therapy.
- Biobanks of tissue and blood from patients enrolled in clinical trials are an invaluable resource in improving our understanding of breast cancer, and identifying which patients are most likely to benefit from specific therapies.
Dr. Sparano is conducting studies to identify biomarkers that will help to evaluate response to treatment and attenuate side effects from hormonal and immunotherapy. Ongoing work includes collection of biosamples to study causes of aromatase inhibitor musculoskeletal symptoms (AIMSS) for research studies that will ultimately help clinicians offer proactive treatment strategies to avoid this syndrome, as well as clinical trials to improve outcomes in patients with metastatic breast cancer.
Full Research Summary
The ECOG-ACRIN Breast Committee performs practice-changing clinical trials in early- and advanced- breast cancer. BCRF has been crucial to the Committee's translational research program, including the collection, management, processing and routing of patient samples collected on ECOG Trials for future research projects.
In the last year, the ECOG sponsored TAILORx study that recently reported on the OncotypeDx® assay for selecting women with early stage estrogen receptor (ER)-positive breast cancer who can forego chemotherapy. The study definitively showed that women with a low Oncotype DX score (0-10) could forego chemotherapy and further showed that most women with an intermediate score (11-25) could also safely forego chemotherapy.
Current efforts include studies to: 1) determine the predictive value of the imaging agent Fluoroestradiol in patients with estrogen-receptor (ER)-positive metastatic breast cancer receiving anti-estrogen therapy; 2) determine if resistance to hormone treatment may be overcomed by the addition of class of drugs called histone deacetylase (HDAC) inhibitors; 3) identify markers which would predict aromatase-inhibitor musculoskeletal symptoms (AIMSS); 4) a phase III clinical trial to evaluate the effect of platinum-based chemotherapy after neoadjuvant therapy in patients with basal-like triple negative breast cancer.
In 2013, the Coalition of Cancer Cooperative Groups, a non-profit member organization of the National Cancer Institute-sponsored Cooperative Groups, created the North American Breast Cancer Groups Biospecimen Bank for Determinants of Late Relapse in Operable Breast Cancer. The NABCG Biospecimen Bank is a unique resource of archived primary and metastatic tumor tissue, blood, and DNA. The purpose for the collection and analysis of samples is to improve our understanding of breast cancer, and identify which patients are most likely to benefit from specific therapies. To date 16,934 blood samples have been collected.
Preliminary data from various small studies indicate a higher risk of recurrence among patients with early stage breast cancer who have detectable circulating tumor cells (CTCs) or circulating tumor DNA in plasma (ctDNA).
The blood and tumor samples are a unique resource that may be used for research to explore possible tumor and host-related factors contributing to recurrence and which may be potentially modifiable via pharmacologic, nutritional or other lifestyle interventions. The analysis of CTCs and generation of an “early stage biorepository” will allow the study of biomarkers and their role in recurrence.
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).