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Julie R. Gralow, MD
Jill D. Bennett Professor of Breast Cancer
University of Washington School of Medicine
Director, Breast Medical Oncology
Seattle Cancer Care Alliance
Member, Clinical Research Division
Fred Hutchinson Cancer Center
Seeking to increase awareness and improve treatment of breast cancers that have spread to the bone.
Studies are ongoing to analyze data from clinical trials to better understand how best to intervene and prevent this disease.
These efforts will inform future strategies to prevent bone metastasis, improve treatment and increase participation of patients with bone metastasis in clinical trials.
Bone is the first site of distant recurrence in 25-40 percent of metastatic breast cancer cases. There is a synergistic interaction between the bone environment and breast cancer cells that enables bone cells to stimulate the growth and survival of breast cancer cells that migrate to the area.
Bisphosphonates are a class of drugs that inhibit the breakdown of bone. In low doses, bisphosphonates can reverse the effects of osteoporosis. In high doses, they have been shown to reduce bone destruction and improve bone symptoms in breast cancer patients with bone metastases, and to reduce and/or prevent bone metastases when given to newly diagnosed, early stage breast cancer patients.
In order to identify and select patients who are most likely to benefit from bisphosphonate treatment, Dr. Gralow and her international colleagues will analyze data on tissue, serum, and DNA biomarkers collected in multiple clinical trials.
A major challenge in improving treatment for breast cancer bone metastases is the low number of patients with bone-only metastases enrolled in clinical trials. To remedy this, a meeting was held in 2017 bringing together medical experts, researchers, pharma, patient advocates and policy makers. Specific discussion revolved around endpoints, imaging, clinical trials, regulatory issues related to metastatic breast cancer patients with bone metastasis and recommendations for further research.
A report and several manuscripts are being prepared to increase awareness and increase clinical trials for patients with bone metastasis.
Julie R. Gralow, MD, is the Jill Bennett Endowed Professor of Breast Cancer at the University of Washington (UW) School of Medicine, Director of Breast Medical Oncology at the Seattle Cancer Care Alliance, and Member of the Clinical Research Division at Fred Hutchinson Cancer Center (FHCRC).
As a clinician-researcher, Dr. Gralow has developed and implemented numerous clinical trials that study new regimens for breast cancer prevention and treatment. She promotes exercise and a healthy diet for improving quality of life among breast cancer patients. She also has an interest in international breast cancer education. Dr. Gralow’s primary research expertise is in the field of breast cancer bone metastases and bisphosphonates (drugs that slow bone cell turnover, leading to a decreased risk of developing bone metastases).
Dr. Gralow is PI for the clinical core of the FHCRC/UW Breast Cancer Specialized Program of Research Excellence (SPORE) grant. She currently serves as an Executive Officer for SWOG overseeing breast and lung cancer efforts. She has served as an alternate member of the NCI Breast Cancer Steering Committee since its inception, and co-chaired an NCI State of the Science conference on preoperative therapy in breast cancer in 2007. She also serves as a member of the Leadership Team of the FHCRC’s application to NCI as a Network Lead Academic Participating Site (LAPS) in the National Clinical Trials Network.