Titles and Affiliations

Director, Carol Franc Buck Breast Care Center
Professor of Surgery and Radiology
Clinical Program Leader, Breast Oncology Program
Alfred A. de Lorimier Endowed Chair in General Surgery
UCSF Helen Diller Family Comprehensive Cancer Center
University of California
San Francisco, California

Research area

To characterize the tumor microenvironment to identify strategies to improve outcomes for breast cancer patients.  

Impact

Immunotherapy is a promising treatment for breast cancer, but currently few patients benefit from it. Identifying those patients that are responsive to immunotherapy would inform treatment decisions to achieve the best possible outcome for patients while avoiding unnecessary toxic side effects. Dr. Esserman and her team demonstrated that the number of immune cells (particularly T cells) and their proximity to tumor cells was associated with a good response to immunotherapy in invasive breast cancer. Their work has also shown, however, that other immune factors play a role in suppressing anti-tumor immune activity. In her current BCRF research, Dr. Esserman is utilizing novel imaging technologies to analyze the immune cell composition of the aggressive tumors found in women of African descent. Results from this work will inform more effective, targeted interventions to treat these patients.    

Progress Thus Far

Dr. Esserman has developed a specialized imaging technology through which they determined the spatial proximity of immune cells to tumor cells and developed  biomarkers panels specific to various immune cells. Her team has used these biomarker panels to determine their potential to predict how patients will respond to treatment, particularly patients of African descent. In the last year and in collaboration with fellow BCRF investigator, Dr. Funmi Olopade, 144 breast cancer tissue samples from African and African American women have been obtained and processed. In addition, Dr. Esserman and her colleagues have optimized and validated two new multiplex staining protocols that will enhance our understanding of the immune microenvironment of these breast cancers.

What's next

Studies are underway to characterize the samples and immune infiltrates from the tumors samples the team has assembled. In the coming year, they will compare the resulting data from Nigerian breast cancer patients with that obtained from African American women with high-risk early stage breast cancer, data available from the I-SPY clinical trials. The highly characterized tumors from the I-SPY clinical trials and the Nigerian cohort assembled by Dr. Olopade will provide a unique opportunity for insight into the biology of tumors that arise in African and African American women.

If it were not for BCRF, we would not have had the funding to pursue the exploration of the tumor immune environment and the role it plays in generating response to standard chemotherapy in combination with immune checkpoint inhibitors. We have leveraged these insights into creating a novel vaccine for high risk in situ cancers, and to explore the basis for response in the most aggressive invasive cancers (triple-negative tumors). These insights are helping us to understand whether African and African American women have similar patterns in their tumor immune environments and how we can use these insights to personalize and optimize treatment.

Biography

Laura Esserman, MD, MBA, an internationally recognized breast surgeon, breast oncology specialist, and visionary in personalized medicine, is revolutionizing breast cancer screening and treatment throughout our nation today. Her breast cancer work spans a spectrum from basic science to public policy issues and the impact of both on the delivery of clinical care. She is a provocative thought leader calling attention to, and finding solutions for, over-diagnosis and over-treatment of breast cancer, especially of DCIS.

Since 2002, Dr. Esserman has led the I-SPY TRIALS, a ground-breaking national public-private collaboration among NCI, FDA, more than 20 cancer research centers, and major pharma and biotech companies. This trial model, which has now become an international model for translational research, is designed to shave several years and tens of millions of dollars off the drug development process. The trial paradigm is now being developed for use in other disease domains.

Additionally, Dr. Esserman led the creation of the University of California-wide Athena Breast Health Network, a learning system designed to integrate clinical care and research as it follows 150,000 women from screening through treatment and outcomes.  As part of the network, she has spearheaded the development of the WISDOM study to learn how to improve breast cancer screening by testing and comparing the safety and efficacy of a personalized screening strategy informed by each woman’s breast cancer risk and preferences against the standard of annual screening.

Dr. Esserman has published more than 300 articles in peer-reviewed journals, and is regularly consulted by prestigious scientific, business, and consumer media including The New York Times, Wall Street Journal, Los Angeles Times, Health Magazine, Prevention Magazine, The Newshour, ABC World News, the NBC Nightly News, the CBS Evening News, and NPR’s Science Friday.

She was included as one of TIME Magazine’s 100 Most Influential People of 2016, and she also received the 2018 Giant of Cancer Care® in Cancer Diagnostics award.

BCRF Investigator Since

1998

Areas of Focus