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Nancy U. Lin, MD
Associate Professor of Medicine, Harvard Medical School
Clinical Director, Breast Oncology Center
Dana-Farber Cancer Institute
Seeking strategies to prevent and treat breast cancers metastasis to the brain and to unravel the mechanisms leading to drug resistance in metastatic breast cancer.
Laboratory and clinical studies are employed in the development and testing of new therapies and combination approaches to prevent metastasis and improve response to targeted therapies.
These studies are advancing the clinical evaluation of much needed systemic treatment options for patient with breast cancer brain metastasis.
Despite the high frequency of brain metastases, especially in patients with advanced HER2-positive or triple-negative breast cancer, there are currently no FDA-approved systemic treatments for this problem. The standard of care for brain metastasis, as it has been for many decades, is radiation therapy (and surgery in select patients).
Systemic treatments hold the promise of treating tumors in both the brain and body, and potentially delaying or even preventing brain metastases from occurring. The team of Drs. Lin, Winer, and Zhao is leading a multi-pronged effort to evaluate new systemic approaches in patients with brain metastases from breast cancer, including the development of laboratory models to test promising treatments, followed by translation into clinical trials.
Several agents, including tucatinib and neratinib, have demonstrated encouraging preliminary evidence of activity, with studies ongoing and/or planned to follow up on these observations. This year, new combinations will be tested in the clinic, including further exploration of CDK4/6 inhibitors and immunotherapy-based approaches.
Overall, the team's work represents the largest broad-based effort to evaluate new systemic options in patients with brain metastases from breast cancer.
Drs. Lin and Winer continue to expand the EMBRACE research study. Over 1,700 patients have been enrolled and, in collaboration with the Broad Institute, a subset of patients will have detailed analysis of circulating tumor DNA in blood and analysis of tumor tissue. These efforts will provide clues to drug resistance.
The hope is that by developing a better understanding of resistance mechanisms, they can identify and prioritize the pathways that are most critical in developing the next generation of treatment strategies.
Dr. Lin is a medical oncologist at Dana-Farber Cancer Institute (DFCI) and Assistant Professor of Medicine at Harvard Medical School. Dr. Lin received her medical degree at Harvard Medical School and subsequently completed her residency in Internal Medicine at Brigham & Women's Hospital and a fellowship in Hematology/Oncology at Dana-Farber/Partners Cancer Care. Since 2012, she has served as Clinical Director of the Breast Oncology Center at DFCI.
Dr. Lin's focus is on developing novel targeted therapies for patients with advanced breast cancer and exploring mechanisms of drug resistance, with a particular interest in patients with breast cancer that has metastasized to the brain. Dr. Lin is leading multiple ongoing and planned clinical trials evaluating a variety of targeted approaches in patients with metastatic breast cancer. Her work is highly collaborative and involves close working relationships with clinicians, laboratory investigators, and patient advocates. Dr. Lin's honors and awards include a Young Investigator Award and Career Development Award from the American Society of Clinical Oncology. She is a member of the Massachusetts Medical Society, American Society of Clinical Oncology, Alliance for Clinical Trials in Oncology, and Translational Breast Cancer Research Consortium.