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Pamela J. Goodwin, MD, MSc, FRCPC
Professor of Medicine
Director, Marvelle Koffler Breast Centre
Marvelle Koffler Chair in Breast Research
University of Toronto/Mount Sinai Hospital
Goal: To prevent breast cancer recurrence in patients with early stage hormone-receptor positive breast cancer.
Impact: Dr. Goodwin is investigating factors that may be associated with late recurrence in women who are completing or recently completed therapy. Identifying predictors of recurrence will allow her to launch clinical trials designed to prevent it.
What’s next: She and her team are enrolling patients in a study they hope will reveal blood factors (tumor markers, etc.) and patient-related factors (diet, stress, etc.) associated with late recurrence.
Many life-threatening/incurable breast cancer recurrences and deaths take place more than 5 years after diagnosis, after completion of therapy, particularly in patients with hormone receptor positive breast cancer. Dr. Goodwin is attempting to identify biomarkers that would reveal patients at high risk of recurrence in the early stage of the disease—a time when doctors are able to take steps to prevent it.
Full Research Summary
Research goal: Identifying factors that may be associated with late recurrence in women diagnosed with early stage, hormone receptor-positive breast cancer.
Impact: Although the vast majority of women diagnosed with hormone receptor-positive breast cancer are disease-free at 5 years, they face a continuing risk of relapse that extends for many years. Their risk may be as high as two to three percent per year, depending on initial tumor stage. Dr. Goodwin is conducting a study of blood and patient-related factors that may be associated with late recurrence in women who are completing or recently completed adjuvant hormonal therapy. If they’re successful in identifying predictors of imminent risk of recurrence, they may be able to identify ways to prevent it.
Current investigation: Dr. Goodwin and her team are enrolling patients in their study of predictors of recurrence. These factors include circulating DNA and tumor cells, tumor markers; stress, diet, physical activity, medication use, trauma, and surgery; and inflammatory and metabolic factors in blood.
What she’s accomplished so far: With ongoing support from BCRF, Dr. Goodwin and her colleagues have established collaborations with four centers in Ontario, the British Columbia Cancer Agency, and EPIC Sciences and identified/enrolled almost 100 women.
What’s next: With continued funding, the team will enroll 1,000 women, analyze the blood and data, and conduct statistical analyses to identify factors that are associated with imminent risk of recurrence.
Pamela Goodwin has been involved in research relating to host factors in breast cancer for over 25 years. Early in her career, she became intrigued with the possibility that patient-related factors, especially obesity, might impact outcomes of women diagnosed with breast cancer. She began a research program that has focused on the role of these factors, including obesity, nutrition, exercise and related factors. She has led studies which investigate the complex interactions between body size, nutrition, exercise and physiologic mediators such as insulin, IGF-I and vitamin D, examining their impact on risk and survival. Dr. Goodwin has expanded this work to investigate the status of long-term breast cancer survivors and the influences of hereditary factors, vitamin D and metformin on outcomes. She currently leads the international Phase III trial (NCIC MA.32) examining the impact on breast cancer outcomes of an insulin lowering drug, metformin, and has an active translational research program examining the interface between host factors and tumor biology in both early and advanced disease.
Dr. Goodwin is Professor of Medicine at the University of Toronto, with cross appointments in Health Policy, Management and Evaluation and in the School of Graduate Studies. She is a Senior Investigator at the Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Director of the hospital's Marvelle Koffler Breast Centre and holds the Marvelle Koffler Chair in Breast Research. She is an Associate Editor of the Journal of Clinical Oncology, has published over 170 research articles, and is active in the clinical management of breast cancer patients.