Kathy D. Miller, MD

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 for these variables. Dr. Miller and her team are investigating these disparities to develop therapies specifically for Black women.

Progress Thus Far

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. 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. Effective FDA approved IL-6 targeted therapies are already in clinical use for autoimmune diseases, but they have not been studied as a part of breast cancer therapy.

What’s Next

Dr. Miller and her team have 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. The trial began enrolling patients at Indiana University in March 2024 and will expand to other sites later this year. Additionally, they are partnering with patient advocates to launch an awareness campaign and bolster recruitment through social media.