Titles and Affiliations
Ballvé-Lantero Scholar in Oncology
Professor, Department of Medicine
Co-Director, Simon Cancer Center Breast Cancer Program
Research area
Developing new treatments specifically for Black women with breast cancer
Impact
A 30-year-old Black woman is twice as likely to die from breast cancer before she reaches age 50 than a 30-year-old white woman. Individual and neighborhood socioeconomic status, access to care, structural racism, and other social determinants of health are factors that impact outcomes. However, disparities persist even when controlling these variables. Dr. Miller and her team are investigating these disparities to develop and test better therapies specifically for Black women. Data from the large, annotated collection of breast cancers from Black and white women from the Women’s Circle of Health Study (WCHS) and normal breast tissue from Black donors (Normal Tissue Bank at Indiana University) both point to important differences in immune pathway activation between Black and white women. Her team is working to understand and define these differences to improve outcomes for Black women.
Progress Thus Far
Dr. Miller and her team identified a unique cell type (the ‘PZP’ cell) that increases inflammation in the normal breast tissue of Black women by producing an inflammatory chemical called IL-6, which has been associated with resistance to chemotherapy and metastasis. The prolonged and heightened inflammatory response in Black women allows tumors to evade immune surveillance, resulting in more aggressive disease. Chronic inflammation ‘exhausts’ the immune system, further exacerbating disparities in outcome. In the lab, the team has generated variants of PZP cells for use in functional studies. Since effective FDA approved IL-6 targeted therapies are already in clinical use for autoimmune diseases, Dr. Miller and her team will test these therapies in breast cancer. They launched a clinical trial to compare IL-6 targeted therapy plus chemotherapy to chemotherapy alone in Black and non-Black women with metastatic triple-negative breast cancer (mTNBC).
What’s Next
Dr. Miller and her colleagues are enrolling patients in the phase 2 clinical trial at Indiana University and Roswell Park and will expand to other sites at Emory and Duke in the coming year. Additionally, they are partnering with patient advocates to launch an awareness campaign and bolster recruitment through social media. In preclinical studies using PZP and breast cancer cell lines, the team will examine the effects of locally produced IL-6 on the immune tumor microenvironment. In addition, they will use a neutralizing IL-6 specific antibody to test whether IL-6 from PZP is responsible for changes in breast cells that contribute to therapy resistance and metastasis in aggressive diseases, such as TNBC.
Biography
Kathy D. Miller, MD is Professor of Medicine and the Ballvé-Lantero Scholar at Indiana University (IU) School of Medicine. She is also the Associate Director for Clinical Research at the IU Melvin and Bren Simon Cancer Center. Dr. Miller’s career has combined both laboratory and clinical research in breast cancer. She was the chair of the ECOG-ACRIN Breast Core Committee from 2014-2017, leaving that role when she was elected Co-Chair of the National Cancer Institute (NCI) Breast Cancer Steering Committee. She spearheaded efforts with Radiology to expand cancer screening studies at IU.
“If not for BCRF, this trial would be a dream instead of a reality.”
