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Kathy S. Albain, MD, FACP, FASCO
Professor of Medicine, Division of Hematology/Oncology
Stritch School of Medicine of Loyola University Chicago
Huizenga Family Endowed Chair in Oncology Research
Director, Breast Clinical Research and Thoracic Oncology Programs
Cardinal Bernardin Cancer Center
Co-Director, Breast Translational Research Program
Department of Oncology
Loyola University Medical Center
Goal: To prevent resistance to treatments for estrogen receptor (ER)-positive and triple-negative breast cancer (TNBC).
Impact: Breast cancer stem cells (BCSCs) are the cells believed to allow breast cancer tumors to resist treatment. Drs. Albain and Osipo are studying a gene called DAXX that blocks BCSCs. The team is investigating how DAXX affects a patient’s response to chemotherapy, as well as other cancer fighting drugs, including PARP-inhibitors that used to treat some triple-negative breast cancers (TNBC). Their work may reveal a way to increase DAXX expression in breast cancer cells and improve patient survival.
What’s next: The team will focus on the role of DAXX as a breast cancer suppressor and as a predictor of response to therapies in both ER-positive and triple-negative disease.
While breast cancers that rely on estrogen for growth can be treated with endocrine (anti-hormone) therapy, resistance to this treatment often develops. Drs. Albain and Osipo are studying a potential biomarker called DAXX that may predict response to endocrine therapy in patients with ER-positive breast cancer. They are also investigating high DAXX expression in TNBC, which appears to improve response to standard chemotherapy and a class of targeted drugs called PARP-inhibitors.
Full Research Summary
Research area: Developing strategies to block the survival of dormant breast cancer stem cells in order to improve patient outcomes.
Impact: Estrogen receptor (ER)-positive breast cancers are treated with endocrine therapy, such as tamoxifen or aromatase inhibitors. While these therapies are effective, resistance remains a major challenge. Drug-resistant tumors continue to grow and are more likely to spread to other organs (metastasize). Drs. Albain and Osipo have discovered several novel pathways that appear to be very important for the survival of breast cancer stem cells—the cells most likely to survive anti-cancer therapies and cause breast cancer recurrence many years later. Their efforts may inform the development of new strategies to block survival of dormant cancer stem cells and reduce drug resistance in ER-positive and triple-negative breast cancer (TNBC).
Current investigation: The team has been investigating novel cancer stem cell biomarkers that can predict the potential for response to treatment as well as resistance to therapy. Their most recent work has been focused on the biomarker DAXX.
What they’ve learned so far: Drs. Albain and Osipo have identified DAXX and Notch as key pathways in the resistance of BCSCs to cancer treatment. Their studies have shown that high amounts of the DAXX gene correlates with a reduction in the number of BCSCs and a better response to endocrine therapy, standard chemotherapy, and PARP-inhibitors in ER-positive and triple negative breast cancer cells. In addition, they have shown that phytoestrogens found in some food products increase the expression of the DAXX gene resulting in a decrease in BCSCs.
What’s next: Drs. Albain and Osipo will now examine breast cancer tissue before and after pre-surgical therapy to determine if the levels of DAXX and other biomarkers predict long term survival in estrogen receptor-positive disease. They will also continue their studies to determine how DAXX can regulate and predict the tumor’s response to chemotherapy and/or PARP-inhibitors in ER-positive and TNBC.
Kathy S. Albain is Professor of Medicine (tenured) at Loyola University Chicago Stritch School of Medicine and is a Dean’s Senior Scholar. As a member of the Division of Hematology/Oncology, she devotes her clinical practice to patients with breast and lung cancer at Loyola’s Cardinal Bernardin Cancer Center. She is Co-leader of the Breast Cancer Program (with Clodia Osipo, PhD), Director of the Breast Clinical Research Program, Co-director of the multidisciplinary Breast Oncology Center, and Director of the Thoracic Oncology Program. Dr. Albain is involved in national research and advisory activities pertaining to breast and lung cancers as well as cancer survivorship and special populations research. She chaired the Committee on Special Populations for SWOG, an NCI cooperative group, from its inception. This committee conducted novel research that addressed gender differences in cancer, survivorship issues, and outcome and treatment of special populations. A lay advocates program was formed under her leadership. Following SWOG reorganization, Dr. Albain served as co-chair of its Cancer Survivorship Committee. She also co-chairs an international breast cancer survivorship collaboration. Dr. Albain is a member of the SWOG working groups for breast and lung cancer. She is a member of the international Early Breast Cancer Trialists’ Collaborative Group and Steering Committee. She was a charter member of the NIH Committee on Research on Women’s Health and completed a term on the FDA Oncologic Drugs Advisory Committee (ODAC). She has over 170 publications in peer-reviewed journals and major textbooks, and is a Fellow of the American College of Physicians.