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Laura van 't Veer, PhD
Professor of Laboratory Medicine
Angela and Shu Kai Chan Endowed Chair in Cancer Research
Leader, Breast Oncology Program
Director, Applied Genomics
University of California
San Francisco, California
Goal: To discover biomarkers that can guide treatment decisions in real-time
Impact: Dr. van ‘t Veer is conducting studies to search for markers that can be used to identify breast cancer patients who are not responding to neoadjuvant therapy, therapy given before cancer surgery. Her discoveries could allow these women to be quickly switched to other treatment options that may be more successful in treating their disease.
What’s next: Using biomarkers they’ve developed, Dr. van ‘t Veer’s team is testing a treatment-switching strategy to switch patients to different treatments when one treatment isn’t working. Alternatively, patients whose tumors are responding to the drug may be able to have surgery sooner.
Many people who are newly diagnosed with breast cancer receive chemotherapy prior to surgery–called neoadjuvant therapy. This helps shrink tumors and allows physicians to determine whether the drug is working well and if a patient should stay on the therapy after surgery. Dr. van ‘t Veer has been developing biomarkers that would quickly identify individuals whose cancers are resistant to certain classes of therapy so that different strategies can be used as soon as possible.
Full Research Summary
Research Area: Using patient data from ongoing clinical trials to identify markers of drug response, thereby maximizing patient outcome, and minimizing exposure to drugs that are not helping.
Impact: Therapy prior to cancer surgery—called neoadjuvant therapy—is commonly used to reduce the size of a tumor to allow for less invasive, breast conserving surgery. How well the tumor responds to neoadjuvant therapy—measured by how much tumor remains at the time of surgery—can be informative about the biology of the tumor and patient prognosis. Waiting until the patient undergoes surgery however to determine whether the drug worked, is a loss of valuable time. The I-SPY 2 trial is a neoadjuvant trial designed to identify biomarkers of response to a variety of drugs. Dr. van ‘t Veer and her colleagues are utilizing this trial platform to identify markers of response that can be used to facilitate the switching of patients to other drugs when one is not working. This strategy will ultimately lead to more effective neoadjuvant therapy and better outcomes for patients.
Current Investigation: Dr. van ‘t Veer and her colleagues are using information obtained from patients participating in I-SPY 2 to identify markers that can allow real-time assessment of tumor response to therapy. This will help inform treatment choices going forward and improve patient outcomes.
What she’s accomplished so far: Dr. van ‘t Veer has developed biomarkers of response using data from pre-treatment tumor biopsies and circulating tumor DNA (ctDNA) that predict response to a variety of therapeutics tested in the I-SPY 2 trial. This trial has enrolled over 3000 patients with over 1750 patients randomly assigned to test more than 19 therapeutic strategies.
What’s next: In the coming year, her team will analyze ctDNA and MRI imaging data from 1500 I-SPY2 patients to determine predictors of tumor response and outcome. They expect this large and powerful cohort will allow them to recognize patterns of biology associated with early response and resistance. To date, Dr. van ’t Veer and her colleagues have established five patterns of biology that highly predicts the likelihood of response to drugs including DNA-repair inhibitors or immune-oncology modulators and will further explore and validate these findings.
Laura van ’t Veer, PhD, is a renowned molecular biologist, Principal Investigator of the Athena Breast Health Network at UCSF and Leader of the Breast Oncology Program in the Helen Diller Family Comprehensive Cancer Center. She is the former Head of Diagnostic Oncology at the Netherlands Cancer Institute, inventor of MammaPrint and co-founder of the molecular diagnostic company Agendia. Dr. van ’t Veer’s research focuses on personalized medicine and aims to advance patient management based on knowledge of the genetic makeup of the tumor as well as the genetic makeup of the patient. This allows physicians to optimally assign systemic therapy for those patients that are in need of such treatment and to ensure the selection of the therapy that is most effective. She is the chair of the Biomolecular Committee of the I-SPY 2 trial ensuring CLIA compliant companion diagnostics in matching patients’ tumor biology to the right drug. Dr. van ’t Veer’s research shows that molecular diagnostics and genomics technology increasingly impact patient management. Molecular genomics contributes to the knowledge of who is at risk for breast cancer, how external factors may influence this risk, whether breast tumors are likely to metastasize or not, and which subtype of tumors will likely respond to what therapy. Dr. van ‘t Veer is the recipient of numerous awards, including the 2015 European Inventor Award.