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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 will identify breast cancer patients who are not responding to preoperative therapy. 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: She and her colleagues will test a treatment-switching strategy using biomarkers they have developed to identify patients who are not responding to treatments and should be switched to another treatment, as well as those who are responding well and can go to 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 identify individuals who are resistant to certain classes of therapy and is now conducting research to determine how non-responders should be treated to increase survival.
Full Research Summary
Research area: Using patient data from ongoing clinical trials to identify markers of response to improve patient care by maximizing benefit and reducing harm.
Impact: therapy—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. Patients with tumors that respond well to neoadjuvant therapy have a much better prognosis then those with tumors that do not. In this way, waiting until surgery to find that the tumor has not responded is a loss of valuable time. Dr. van ‘t Veer and her colleagues aim to improve response to neoadjuvant therapy for more patients by identifying markers of response that can allow a patient to try another drug when one is not working.
Current research: The I-SPY 2 trial is a neoadjuvant trial designed to identify biomarkers of response to a variety of drugs. It allows patient who are not responding to be switched to another drug that may be more beneficial. Dr. van t’ Veer and her colleagues aim to use information obtained from patients participating in I-SPY 2 identify markers that can inform allow for real-time assessment of tumor response to therapy to give patients another chance and improve survival rates.
What they’ve learned 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
What’s next: In the coming year, her team will analyze data across 1500 I-SPY2 patients for whom short-term response and up to five-year survival data are known. They expect this large and powerful cohort will allow them to recognize patterns of biology associated with early response and resistance.
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.