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Kathy S. Albain, MD, FACP
Director, Breast Clinical Research Program
Co-Director, Breast Oncology Center
Director, Thoracic Oncology Program
Professor of Medicine, Stritch School of Medicine
Loyola University Chicago
Targeting breast cancer stem cells to prevent resistance to treatments for estrogen receptor-positve and HER2-driven breast cancers.
A clinical trial is planned to test new biomarkers to predict a complete response to standard therapy.
Targeted therapies that reduce the number of breast cancer stem cells will improve treatment response and prevent metastasis.
Breast cancer is a mixture of subtypes defined by tumor biomarkers: hormone receptor-positive (ER/PR), HER2-positive, or triple negative (lacking ER, PR, HER2). ER-positive subtypes are treated with endocrine therapy, such as tamoxifen or aromatase inhibitors. However, resistance to endocrine therapy remains a major clinical concern as drug-resistant tumors continue to grow and are more likely to spread to other organs (metastasize).
Drs. Albain and Osipo have been studying the role of the Notch signaling pathway in breast cancer for more than a decade and have shown that Notch is responsible for resistance to endocrine and anti-HER2 therapy. This could be due to its role in helping breast cancer stem cells survive. These stem cells lay dormant and evade therapy, ultimately causing tumor progression upon reactivation.
They recently discovered a novel treatment that targets Notch and causes a decrease in breast cancer stem cells. They have also identified potential biomarker that may predict response to this treatment in patients. They are continuing these studies to understand how the treatment works to promotes the destruction of breast cancer stem cells and pursue other potential biomarkers.
These biomarkers together could also be used to select patients for in a future clinical trial of combination therapy with a Notch inhibitor plus other targeted therapies and to monitor response to treatment. Overall, strategies to block survival of dormant cancer stem cells will improve patient outcomes.
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.