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Laura Biganzoli, MD, PhD
Breast Unit Coordinator
Hospital of Prato
Istituto Toscano Tumori
Goal: To discover new biomarkers to predict the risk of breast cancer recurrence.
Impact: Drs. Biganzoli and Fornier are studying the metabolomic profile found in blood samples from women with early-stage breast cancer to determine whether they can be used to predict the likelihood of the breast cancer recurring. By identifying women at high risk of recurrence, treatment can be tailored to each patient.
What’s next: The team will expand their ongoing retrospective and clinical trials this year and continue to evaluate the metabolite profile of blood from patients with early-stage breast cancer.
Aggressive treatments aimed at reducing the risk of breast cancer recurrence such as chemotherapy can be difficult for patients to endure. Unfortunately, there are limited ways to help determine which patients benefit the most from chemotherapy, so some patients receive unnecessary chemotherapy. Drs. Biganzoli and Fornier are investigating how metabolites found in the blood of breast cancer patients could allow doctors to precisely identify those who require aggressive treatments like chemotherapy and those who can avoid them.
Full Research Summary
Research area: Seeking biomarkers that would help identify women with early breast cancer who are more likely to have their cancer return after surgery.
Impact: Approximately 25 percent of patients with early stage breast cancer will be diagnosed with metastatic breast cancer. Recurrence is a serious clinical challenge, in part because doctors have limited tools that predict which patients are at the greatest risk of relapse—information that would help guide treatment. Drs. Biganzoli and Fornier are identifying metabolites (the molecules that occur as a result of cell activity) which would allow doctors to better identify those who require aggressive treatments, such as chemotherapy, and those who can avoid them. The results of their studies will potentially lead to refinements in risk assessment and the personalization of treatment.
Current investigation: The team is investigating whether metabolomic analysis of blood can refine the risk prediction of the genomic assay OncotypeDX® in patients with early hormone receptor-positive, HER2-negative breast cancer.
What they’ve learned so far: The team has conducted a retrospective proof-of-concept study and demonstrated that metabolomic analysis can split existing Oncotype-defined recurrence risk groups and identify patients at the highest risk of relapse and recurrence. In the last year, they have expanded their study and have demonstrated that this analysis can distinguish between patients with early breast cancer and those with metastatic breast cancer. Moreover, patients with early breast cancer who have metabolites resembling the metastatic profile are more likely to relapse.
What’s next: Drs. Biganzoli and Fornier will continue to validate their findings in a larger cohort of patients and, refine the existing tests and assessments. Ultimately, these studies will help to differentiate between patients who are at greatest risk of breast cancer recurrence and require more aggressive treatment and those who can avoid unnecessary chemotherapy, allowing doctors to tailor their adjuvant treatment accordingly.
Laura Biganzoli is the Director of the Breast Center at the Hospital of Prato, Istituto Toscano Tumori, Prato, Italy. She earned her medical degree at the University of Pavia, Italy, and completed fellowships at the National Cancer Institute of Milan and at the Jules Bordet Institute in Brussels. For five years she worked as a senior staff member at the Medical Oncology Clinic of the Jules Bordet Institute. She is board certified in medical oncology and internal medicine. Her current research focuses on breast cancer and geriatric oncology. Dr. Biganzoli was the Director of the European Organization for Research and Treatment of Cancer (EORTC) Investigational Drug Branch for Breast Cancer, dedicated to the conduction of early phase II studies in advanced breast cancer, for five years and sat on the Board of Directors of the Breast International Group (BIG) from 1999 to 2003. Dr. Biganzoli has been a member of the European Society of Breast Cancer Specialists (EUSOMA) Executive Committee since 2011 and European Society of Medical Oncology (ESMO) Faculty Member for the Elderly since 2012. She is part of the International Society of Geriatric Oncology (SIOG) Science & Educational Committee.