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Nikhil Wagle, MD
Assistant Professor in Medicine, Harvard Medical School
Deputy Director, Center for Cancer Precision Medicine
Associate Member, Broad Institute
Dana Farber Cancer Institute
Goal: To generate a clinical and genomic landscape of metastatic breast cancer through patient-partnered research.
Impact: While treatments have improved for metastatic breast cancer (MBC), there is no cure for this disease. Dr. Wagle launched the MBCproject, a national registry of patients with MBC eager to engage in research that will lead to a better understanding of the genomic and clinical landscape of this disease. Patient volunteers register on the MBCproject website and may elect to provide consent to clinical data as well as tumor biopsies, blood and saliva that is used for genomic analysis. Data generated from the project is providing new insights into MBC, potential new targets for drug development and a valuable resource for future research.
What’s next: In the coming year, Dr. Wagle and his team will continue analyses from the MBCproject focusing on applying machine learning and artificial intelligence technologies to abstract data from medical records of 5,000 MBCproject participants, as well as integrating and analyzing clinical, genomic, pathologic and patient reported data from over 500 patients with MBC.
An estimated 150,000 women and men in the U.S. are living with MBC and more than 40,000 people in the U.S. die from MBC each year, representing 7 percent of cancer deaths. In order to make advances in the study of MBC, researchers need access to clinical samples and patient information. Most cancer patients, however, are treated in community settings where this type of research is not done. To address this, Dr. Wagle and his team launched the MBCproject, a research study that directly engages patients through social media and advocacy groups, and empowers them to share samples, clinical data, and experiences. The goal is to create a publicly available database of genomic, molecular, clinical, and patient-reported data to enable research – thereby accelerating discoveries that will lead to new treatments and treatment strategies for this disease.
Full Research Summary
Research area: To accelerate treatments and improve outcomes for patients with metastatic breast cancer though patient-empowered research.
Impact: Metastatic breast cancer (MBC)– breast cancer that has spread beyond the breast – is a complex disease. Studying MBC is also complicated by the fact that many MBC patients are excluded from or do not have access to clinical trials. The MBCproject led by Dr. Nikhil Wagle, seeks to address the challenges in studying MBC at the clinical, genomic and patient level by enrolling patients in a registry where they can elect to provide access to their clinical and medical data, as well as tumor biopsies, blood and saliva for DNA sequencing. Data from the study is de-identified to protect patient security and shared with the research community through a free database, allowing researchers around the world to access the data for other research studies. These efforts will aid the development of personalized therapy for patients with MBC, as well as inform the development of new therapeutic strategies, including targeted drug combinations or novel therapeutic agents.
Current research: The research team continues to enroll patients to the MBCproject, with an emphasis on outreach efforts to increase enrollment from the African American community. They utilize patient and clinical data as well as genomic data from tumor tissue, blood and saliva to generate a genomic and clinical landscape of the disease that will inform future research.
What they’ve accomplished so far: The MBCproject has enrolled over 5,000 patients representing all 50 U.S. states and Canada. In the last year, Dr. Wagle’s team focused on recruitment from the African community, registering 155 AA women into the project. Despite a dedicated effort to increase enrollment by AA women, it remains a challenge and currently only 3 percent of MBCproject participants report being African American.
What’s next: The team will continue its efforts to increase participation among AA women through a variety of outreach efforts to foster trust and build relationships. In addition, they will begin efforts to improve medical record data extraction by employing machine learning technologies and integrate and analyze genomic, pathologic and patient reported data from MBCproject participants.
Nikhil Wagle is an Assistant Professor of Medicine at Harvard Medical School, a medical oncologist at Dana-Farber Cancer Institute, and an associate member of the Broad Institute of MIT and Harvard. He is the Deputy Director of the Center for Cancer Precision Medicine at Dana-Farber Cancer Institute. He received his MD from Harvard Medical and completed his residency training in internal medicine at Brigham and Women’s Hospital, where he also served as chief medical resident, and completed his fellowship training in hematology/oncology in the Dana-Farber/Partners program.
Dr. Wagle leads a translational research program in the field of breast cancer genomics and precision (or “personalized”) cancer medicine. The major goals of his work are to better understand the biology of metastatic breast cancer and to develop new ways to overcome or prevent drug resistance in patients with advanced breast cancer. Ultimately, his research aims to identify characteristics of tumors that might improve clinical decision-making for patients with advanced cancer.
He also leads The Metastatic Breast Cancer Project (mbcproject.org), a nationwide direct-to-patient research initiative that engages patients with advanced breast cancer through social media and seeks to empower them to accelerate cancer research through sharing their samples and clinical information. The project’s outreach program, developed in collaboration with advocacy organizations and patients, serves to connect thousands of patients around the U.S. with metastatic breast cancer research, allowing them to participate regardless of where they live.