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Laura J. Esserman, MD, MBA
Professor of Surgery and Radiology
Director, Carol Franc Buck Breast Care Center
Co-Leader, Breast Oncology Program
UCSF Helen Diller Family Comprehensive Cancer Center
University of California
San Francisco, California
Seeking to identify biomarkers (molecular flags) that can predict response to therapy or risk of recurrence.
Tumor infiltrating immune cells and the gut microbiome are analyzed in ethnically diverse populations to identify biomarkers of response to immunotherapies.
This research will lead to more personalized and effective cancer care by advancing immune-based diagnostic and therapeutic strategies to the clinic.
Interactions between tumor cells and host immune cells are quite complex, and are not adequately characterized by conventional staining techniques, nor by assays that require single tumor cells. Dr. Esserman’s team is utilizing new technologies for multiplexed analyses of immune cell infiltrates with the goal of bringing immune-based diagnostic and therapeutic strategies into the clinic.
They have designed two panels of immune biomarkers for characterizing the tumor immune microenvironment. This year they will test these panels in patients from the I-SPY 2 trial, as well as in women from West Africa (in collaboration with BCRF investigator, Dr. Funmi Olopade). Breast cancer in women of African descent tend to be high grade, triple negative, and very aggressive, and may show features that predict high sensitivity to immune drugs.
Dr. Esserman is also studying the relationship between the human microbiome, which includes all of the microbes found in and on the human body and cancer risk. The microbiome is altered in many diseases and may substantially affect cancer risk in several ways, including immune modulation and inflammation.
The team has shown that the gut microbiomes of women with breast cancer differ from those of healthy women. This year, they will extend their microbiome studies, which to date have predominantly enrolled Caucasian women, to a cohort of African American women. They will also begin a small pilot study to test the feasibility of a prevention study with oral lactobacillus in women at high risk of developing breast cancer.
Dr. Esserman is a surgeon and breast cancer oncology specialist, and is the Director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco (UCSF). In 1996, she started the Center of Excellence for Breast Cancer Care at UCSF to integrate clinical care and research, automate tools for the capture of patient and clinical data, and develop systems to tailor care to biology, patient preference, and performance.
Dr. Esserman is nationally and internationally known as a leader in the field of breast cancer and has published over 200 articles. She served as a member of a taskforce for President Obama’s Council of Advisors on Science and Technology (PCAST) Working Group on Advancing Innovation in Drug Development and Evaluation. The group was tasked with making recommendations to the federal government about how to best support science-based innovation in the process of drug development and regulatory evaluation.
She is the Principal Investigator of the I-SPY TRIAL program, a multi-site neoadjuvant clinical trial (which includes a phase 2 and 3 trial) that has evolved into a model for translational research and innovation in clinical trial design. Dr. Esserman has recently launched a University of California-wide breast cancer initiative called the Athena Breast Health Network, a program designed to follow 150,000 women from screening through treatment and outcomes, incorporating the latest in molecular testing and web-based tools into the course of care. Athena is in the final stages of launching a statewide demonstration project and phase 1/2 trial of personalized screening.