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Joseph A. Sparano, MD
Professor at Albert Einstein College of Medicine
Vice-Chair, ECOG-ACRIN Cancer Research Group
Goal: To identify biomarkers that will help evaluate response to treatment and reduce side effects, 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 inform personalized treatment approaches and improved outcomes for breast cancer patients.
What’s next: In addition to continuing his current study, Dr. Sparano and his team will analyze ILC tumor samples in order to gain much-needed insight into this understudied form of breast cancer.
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 response to treatment and limit side effects from hormonal and immunotherapy. This year, Dr. Sparano will continue to retrieve and process samples for such investigations, and he also plans to evaluate tumor samples of invasive lobular cancer (ILC), an understudied from of ER-positive breast cancer.
Full Research Summary
Research area: To improve treatment outcomes and reduce the risk of breast cancer recurrence by identifying biomarkers to inform treatment decisions.
Impact: In spite of the tremendous progress in breast cancer treatments, far too many patients ultimately succumb to their disease due to treatment failure and breast cancer relapse. Understanding why a treatment fails and what makes some patients at greater risk of relapse than others will have tremendous impact in further reducing breast cancer deaths. Clinical trials are a key component in improving treatments for patients with breast cancer, but they also provide a rich resource for patient samples that can be used to identify biomarkers of response or risk of recurrence.
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. These efforts led to the most recent discovery from the TAILORx trial that 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 increased risk of breast cancer recurrence. These studies are advancing precision medicine, where a patient’s treatment is guided by molecular characteristics of the tumor.
Current research: Dr. Sparano will oversee ongoing efforts in the analysis of samples from the Late-Relapse Repository and ECON-ACRIN trials. Specifically, ongoing trials will include the analysis of samples to examine biomarkers which: indicate a painful side effect that limits anti-estrogen therapy in some women; predict benefit from a novel combination treatment for ER+ disease; and, indicate which patients benefit from additional chemotherapy. They will also begin a new initiative to focus 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 and the presence of tumor cells in the blood indicate a higher risk of relapse in patients who have been disease free for at least 4 years.
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 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).