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Padma Sheila Rajagopal, MD, MPH
Postdoctoral Fellow, Hematology/Oncology
University of Chicago
Conquer Cancer Foundation of ASCO
Goal: To develop clinical prognostic tools for use across breast cancer subtypes and in diverse populations.
Impact: Prognostic tools, such as Oncotype Dx and MammaPrint, are effective at categorizing patients by their risk of recurrence for treatment decision purposes. However, these tools were developed and tested in patient cohorts comprised predominantly of women of European descent and are designed for estrogen receptor-positive breast cancer. Dr. Rajagopal’s goal is to develop prognostic models that will be usable across breast cancer subtypes and across diverse patient populations for improved care.
What’s next: Dr. Rajagopal and her colleagues will use a computational method to identify genes associated with the clinical outcome in patients of African descent and then test it across other populations.
Gene-based predictive assays have advanced precision medicine by helping to predict a patient’s risk of recurrence and guide treatment decisions. These assays, however, have been developed from data in women of European descent and may not translate to other populations. Dr. Rajagopal and her colleagues will look for common gene variations in women of African ancestry that may contribute to increased risk of developing breast cancer. They will develop a prognostic tool and validate it against multi-ethnic datasets.
Full Research Summary
Research area: To develop a novel, clinically relevant, integrated score with the potential to offer prognostic information that is applicable to more breast cancer patients than current prognostic methods.
Impact: Not all patients have access to risk prediction tools that can provide information on prognosis and inform treatment decisions. Most current tests are limited to early-stage, hormone responsive breast cancers and may not account for ethnic variations in tumor mutation profiles. Women of African ancestry experience higher rates of both hormone-receptor negative and HER2-positive disease and have a higher risk of death compared to Caucasian women, regardless of breast cancer subtype. In an effort to ensure accurate and personalized risk assessment for every breast cancer patient, Dr. Rajagopal and her colleagues will develop a multi-ethnic prognostic score model that can be used regardless of breast cancer subtype.
Current investigation: Dr. Rajagopal and her team will apply computational methods that incorporate information from multiple molecular and clinical variables to generate a prognostic score. Their method will allow for the incorporation of tumor characteristics relating to ethnic background so that the test is applicable to multiple breast cancer subtypes and diverse populations.
Padma Sheila Rajagopal, MD MPH is a third-year hematology/oncology fellow at the University of Chicago. Sheila previously completed an undergraduate honors thesis on translational cancer genetics in the lab of Dr. Funmi Olopade at the University of Chicago. She earned her medical degree at Columbia University’s College of Physicians and Surgeons. Between her 3rd and 4th years of medical school, Sheila completed a Master of Public Health (MPH) focused on Quantitative Methods in genetic epidemiology at the Harvard School of Public Health. She completed residency training in internal medicine at the University of Pittsburgh. Her undergraduate and MPH training developed her interest in genetics, while her medical training spurred her interest in the evolutionary development of tumors from germline to metastasis.
She is currently conducting her postdoctoral research under Dr. Olopade as well as Professor Hae Kyung Im. Her goals as a postdoctoral fellow in clinical oncology are to (1) integrate training in clinical cancer genetics, statistical genetics, and bioinformatics into the practice of oncology as a physician-scientist and (2) to explore interactions between germline variation and somatic development of tumors in order to improve clinical prognosis, prediction, and guidance for breast cancer patients.