Kevin Kalinsky, MD, MS
Associate Professor, Department of Hematology and Medical Oncology
Louisa and Rand Glenn Family Chair in Breast Cancer Research
Director, Glenn Family Breast Center
Director, Breast Medical Oncology
Winship Cancer Institute of Emory University
Refining and identifying new biomarkers for risk to better personalize therapeutic strategies in early-stage breast cancer.
The RxPONDER clinical trial was immensely valuable for identifying the right treatment for patients with early-stage hormone receptor (HR)-positive, HER2-negative breast cancer. In the study, patients were defined by their recurrence score which was calculated based on the results of a genomic test called OncotypeDX®. In those who had a low recurrence score (less than 25), the study found no added benefit of chemotherapy in postmenopausal patients whose cancer had spread to three or fewer lymph nodes. In premenopausal women the opposite was true, they benefitted from chemotherapy. This study was groundbreaking, and Dr. Kalinsky and his team will pursue further research to build upon its findings and make its results more universal and accessible for patients.
The team will pursue two separate questions in their study. The first will reassess how menopause is classified in patients. In RxPONDER, menopausal status was based upon self-reported menstrual history, but this can be an imperfect measure. The team will instead explore if menopause can be defined by hormone levels measured in RxPonder patient samples prior to start of treatment. They will evaluate if patient outcomes differ based on the criteria used to define menopause: blood hormone levels versus menstrual history. In the second part of their study, the team will test an alternative method for identifying recurrence scores, as OncotypeDX® is an expensive, laboratory-based test. They will use a computer-aided diagnosis method called CHIP, which generates a risk score based on image analysis of tumor samples for unique cellular arrangements and characteristics. Ultimately, the team will assess if a CHIP recurrence score might be a less costly alternative to OncotypeDx®.
Kevin Kalinsky, MD, MS, is Associate Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. He serves as the director of the Glenn Family Breast Center at Winship where he is tasked with fulfilling the vision to improve breast cancer outcomes by aligning research and education with cancer treatment and prevention. A breast cancer physician and investigator, Dr. Kalinsky's research involves the development of early-phase clinical trials to assess novel therapeutics in breast cancer based on tumor genomics. Breast Cancer Research Foundation funding has been dedicated to further understanding the risk of late recurrence in patients with estrogen-driven breast tumors through novel blood markers as well as artificial intelligence.
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