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Judy E. Garber, MD, MPH
Chief, Division of Cancer Genetics and Prevention
Susan F. Smith Chair
Dana-Farber Cancer Institute
Professor of Medicine
Harvard Medical School
BCRF Scientific Director
Goal: To identify blood markers that can predict long-term outcome in patients.
Impact: Dr. Garber is analyzing the blood of breast cancer patients to look for gene mutations called clonal hematopoiesis of indeterminate potential (CHIP) that could increase the risk of developing blood cancer and heart-related diseases. Her work may be important in preventing additional cancers after breast cancer therapy.
What’s next: She and her team will continue to study whether chemotherapy increases the rate of CHIP in breast cancer patients and determine whether the levels of CHIP decline or increase with time after treatment. Dr. Garber is also examining CHIP in patients who had triple-negative breast cancer (TNBC) and, with BCRF collaborator Dr. Ganesan, is looking at whether certain growth factors have an immediate effect on CHIP and bone marrow cells.
Some breast cancer treatments can increase a patient’s risk of developing a subsequent cancer because of damage that occurs to healthy cells. For example, researchers have discovered the presence of gene mutations that increase the risk of blood cancers in ovarian cancer patients treated with chemotherapy. Dr. Garber is exploring whether this same phenomenon occurs after breast cancer treatment and how it may affect patient outcomes.
Full Research Summary
Research Area: Studying the impact of breast cancer treatment on healthy cells to identify women who may be at risk of recurrence or treatment complications.
Impact: As people age, it is not uncommon to acquire gene mutations called clonal hematopoiesis of indeterminate potential (CHIP), which can increase the risk of blood cancers. CHIP is more prevalent in people who have undergone chemotherapy and are also associated with more toxicity and less benefit of cancer treatment. Dr. Garber’s study may help identify women who should be followed more closely for early signs of recurrence (or of treatment complications) and those that should be treated differently in the future if their cancer does recur.
Current research: Dr. Garber’s studies are focused on determining whether chemotherapy increases the rate of CHIP in breast cancer patients, and whether the levels of CHIP decline or increase over time.
What she’s accomplished so far: She and her team have been collecting blood samples from women newly diagnosed with breast cancer before they begin treatment and at 6 months following treatment to determine whether they have CHIP. They have also been analyzing blood samples previously collected from women with metastatic triple-negative breast cancer (TNBC) to determine if the presence of CHIP in their blood at recurrence is associated with duration of survival.
What’s next: Dr. Garber and her team will complete collection of samples and determine how often treatment causes CHIP and what affect CHIP has on treatment benefits or toxicity. In collaboration with BCRF investigator Dr. Shridar Ganesan she will determine whether growth factors commonly used in combination with chemotherapy to lower the risk of infection have an immediate effect on CHIP and bone marrow cells.
Judy E. Garber, MD, MPH is the Director of the Center for Cancer Genetics and Prevention at Dana-Farber Cancer Institute, Attending physician at the Brigham and Women’s Hospital, and Professor of Medicine at Harvard Medical School.
Her interests focus on breast cancer genetics, risk reduction and the development of therapeutics for the treatment and prevention of breast and related cancers in individuals carrying predisposing mutations. Her research includes the study of basal-like breast cancer, common in women with BRCA1 mutations. Her first neo-adjuvant trial of cisplatin in patients based on the role of BRCA1 in DNA repair demonstrated a significant complete response rate that has led to a series of trials, including a randomized phase II international, multicenter trial. Her research also includes the evaluation of novel agents targeting DNA repair defects in the treatment and prevention of triple negative or basal-like breast cancer, particularly platinums, PARP inhibitors and RANK ligand inhibitors.
Dr. Garber was elected to the National Academy of Medicine in 2013. She is a past president of the American Association for Cancer Research and a member of the National Cancer Advisory Board. She also served on the Board of Scientific Counselors of the National Cancer Institute. She has been a member of the BCRF Scientific Advisory Board since 2008.