Titles and Affiliations
Associate Member
Chief of Disparities, Department of Surgery
Memorial Sloan Kettering Cancer Center
Associate Attending Surgeon, Memorial Hospital for Cancer and Allied Diseases
Associate Professor of Surgery
Weill Medical College of Cornell Medical University
Research area
Evaluating whether reducing a patient’s stress response using a non-selective beta blocker can improve treatment response during neoadjuvant chemotherapy.
Impact
An individual’s neighborhood impacts many aspects of their life, with individuals in disadvantaged neighborhoods experiencing limited access to healthcare, healthy food, clean air and water, among other factors. Despite significant advances in breast cancer screening, diagnosis, and treatment, women living in disadvantaged neighborhoods continue to have higher breast cancer mortality rates than those in more advantaged areas.
Prior work has shown that patients living in more disadvantaged areas are less likely to achieve a pathologic complete response—meaning the tumor is completely eliminated by treatment—and are more likely to show elevated sympathetic nervous system activity in their tumors and blood biomarkers. Building on these findings, this clinical trial aims to evaluate whether a non-selective beta blocker—a medication that blocks the body’s sympathetic nervous system, or “fight or flight” response—can improve treatment response in the neoadjuvant setting, which is associated with improved long-term outcomes.
This clinical trial is critical for evaluating whether reducing a patient’s stress response during neoadjuvant chemotherapy can improve pathologic complete response rates, a surrogate marker for improved survival. Higher pathologic complete response rates, in turn, reduce the need for additional surgical procedures, chemotherapy, and radiation—all of which improve patient quality of life.
What’s next
This study will evaluate the effect of propranolol, a non-selective beta blocker, on pathologic complete response rates—a surrogate for how effectively chemotherapy eradicates the tumor—as well as its potential to reduce cardiac complications in patients receiving neoadjuvant chemotherapy. Improving pathologic complete response rates is associated with improved survival and may also allow patients to undergo less extensive lymph node surgery (reducing rates of lymphedema), allow for higher rates of lumpectomy over mastectomy, and reduce the need for additional adjuvant treatments such as chemotherapy or radiation.
Biography
Neha Goel, MD is an Associate Member and Chief of Disparities in the Department of Surgery at Memorial Sloan Kettering Cancer Center. She is also an Associate Attending Surgeon at Memorial Hospital for Cancer and Allied Diseases and Associate Professor of Surgery at Weill Medical College of Cornell Medical University. Prior to these appointments, she was an Associate Professor of Surgery, surgical oncologist and scientist, and social epidemiologist at Sylvester Comprehensive Cancer Center, a part of University of Miami Health Systems at the University of Miami Miller School of Medicine. She has vast clinical expertise in the multidisciplinary management of breast cancer, melanoma, and sarcoma and is an internationally recognized expert in cancer disparities.
Dr. Goel received her medical degree from University of Illinois College of Medicine at Chicago in 2010 and completed a general surgical residency at Columbia University Medical Center in New York City. She also has a master’s in public health from Harvard T. Chan School of Public Health in Boston and has completed several other fellowships and training: at Harvard Medical School’s Brigham and Women’s Hospital she completed a surgical critical care fellowship and a research fellowship at the Center for Surgery and Public Health; and at Fox Chase Cancer Center in Philadelphia, she completed a complex general surgical oncology fellowship.
Dr. Goel established and leads the Miami Breast Cancer Disparities Study, a prospective epidemiologic cohort study to understand multilevel pathways of breast cancer disparities. She is currently the principal investigator on multiple grants dedicated to using translational epidemiologic approaches to discover targeted therapies and cancer control interventions for diverse racial/ethnic and socioeconomically vulnerable populations, with the ultimate goal of improving cancer health equity.
