Moien Kanaan, PhD

Increasing genetic screening and advancing the understanding of inherited risk factors in diverse populations in the Middle East.

Impact

BRCA genes are the most common genes known to be associated with an increased risk of hereditary breast and ovarian cancer. When working correctly, BRCA1 and BRCA2 are tumor suppressor genes that protect the body from DNA errors that can lead to cancer. Mutations in the BRCA genes that cause them not to function correctly are highly prevalent among people of Ashkenazi Jewish (AJ) ancestry. Israel, which has a large AJ population, offers some of the best genetic screening and follow-up services in the world. However, screening and services have been lacking for Arab and Palestinian women. The Middle East Breast Cancer Study (MEBCS), led by BCRF Investigators Moien Kanaan, Ephrat Levy-Lahad, and Mary-Claire King, seeks to address this disparity.

Progress Thus Far

The goals of the MEBCS are to determine the genetic basis of inherited predisposition to breast cancer among Palestinian and Arab-Israeli women and to create the necessary infrastructure for cancer genetics services for women in this population. The MEBCS has made significant progress and has thrived for 15 years despite challenges posed by a worldwide pandemic and recent conflicts in the area. Genetic testing for Palestinian women is now comparable to services provided anywhere in the world. The study cohort now comprises over 1,500 Palestinian patients with invasive breast cancer and about 400 members of their families.

This year, the team characterized a mutation in the tumor suppressor gene TP53 unique to the Palestinian population. They found that, unlike most inherited TP53 mutations, the mutation found in the Palestinian population is not associated with increased risk for cancer in children. This finding directly informs care of all patients with similar TP53 mutations. Dr. Kanaan recently opened a cancer genetics clinic at Ishtishari Hospital in Ramallah, serving patients referred by oncology services from throughout the region. The team has also created training programs in cancer genetics for Palestinian nurses and social workers.

What’s next

In the coming year, the team will use next generation genomic technologies to identify and characterize new classes of actionable mutations in Palestinian patients with breast cancer. They will continue to develop their successful genetics testing and counseling programs in Bethlehem and Ramallah. By identifying previously unknown genetic causes of breast cancer, their work will benefit patients and their families not just in the Palestinian and Arab populations but worldwide.