Joseph A. Sparano, MD

Identifying factors that contribute to the late recurrence of breast cancer and determining if circulating tumor DNA can be used to personalize treatment decisions for patients, prevent relapse, and improve survival.

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. 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. Dr. Sparano oversees ongoing data analysis of samples from the Late-Relapse Repository and ECOG-ACRIN trials to identify and validate markers from patient tissue and blood to improve personalized treatment approaches and outcomes for breast cancer patients.

Progress Thus Far

Ongoing work is focused on several areas, including tumor-infiltrating lymphocytes (TILs), genomic assays, circulating tumor DNA (ctDNA) and circulating methylation markers. In the last year, Dr. Sparano and ECOG-ACRIN? collaborators have developed a new prognostic tool, called RSClin Late, that provides prognostic information for late breast cancer recurrence between years 5-10 after diagnosis for women with estrogen-receptor-positive, HER2-negative, axillary node negative early-stage breast cancer. The new tool integrates prognostic information provided by the Oncotype DX 21-gene Recurrence Score, plus age at diagnosis, tumor size, and tumor grade; it is now widely used in clinical practice to help individuals estimate their recurrence risk with greater precision, which may help them individualize their decision to continue adjuvant endocrine therapy for more than 5 years.

What’s next

Dr. Sparano is launching a new initiative—the Tumor Evolution and escApe to Metastasis (TEaM) project—in collaboration with BCRF Investigator Dr. Christina Curtis to better understand tumor cell and microenvironmental factors that contribute to breast cancer late recurrence. This collaboration will utilize the biospecimen resources Dr. Sparano has established through ECOG-ACRIN to better understand tumor cells and tumor microenvironmental factors that contribute to breast cancer recurrence, especially late recurrence. Dr. Sparano’s group is also launching a new NCTN biospecimen collection trial, EA1241, that will collect relapse tumor specimens from patients who participated in the TAILORx and RxPONDER trials and had a cancer recurrence. They will conduct molecular analysis with the goal of providing greater insight into the molecular mechanisms driving cancer recurrence. Ongoing research utilizing TAILORx biospecimens includes deep learning and artificial intelligence approaches for analyzing pathologic images of tumor specimens that will provide insights into recurrence risk and molecular characterization of tumor specimens that may define molecular alterations influencing cancer progression, recurrence, and treatment benefit.