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Priscilla Brastianos, MD
Director, Central Nervous System Metastasis Program
Assistant Professor of Medicine
Massachusetts General Hospital, Harvard Medical School
Goal: To identify new strategies for the prevention and treatment of breast cancer that has spread to the brain.
Impact: Dr. Brastianos aims to understand the genetic and molecular mechanisms that drive the spread of breast cancer to the brain. Her work could ultimately identify therapeutic opportunities for the 300,000 patients each year diagnosed with with brain metastases.
What’s next: She and her team will continue to genomically characterize tumor tissue samples from patients with brain metastasis, which they hope will reveal why some patients are resistant to treatment and identify new potential targets for drug development.
Breast cancer can spread to other sites in the body – a process called metastasis – and the brain is one of the more common organs it invades. In fact, this occurs in more than a third of patients with advanced breast cancer, up to 300,000 patients year. The prognosis of cancer patients who develop brain metastasis is poor, with only 20 percent of patients surviving at one year. Dr. Brastianos is conducting studies to characterize the genetic and molecular profiles of brain metastasis compared to primary breast cancer with the goal of identifying potential targets for therapy and strategies to improve response to existing therapies.
Full Research Summary
Research area: Identifying new therapeutic opportunities for breast cancer patients with brain metastases.
Impact: While advances in cancer therapies have improved the ability to control breast cancer outside of the brain, more breast cancer patients are dying of brain metastases. Breast cancer that spreads to the brain occurs in more than a third of patients with advanced breast cancer. Once this happens, prognosis is poor, with only 20 percent of patients surviving at one year. Dr. Brastianos is conducting genetic analyses of brain metastases and primary tumors in order to uncover new therapeutic targets that would reduce deaths due to breast cancer brain metastasis.
What she’s learned so far: Dr. Brastianos continues to build the brain metastasis tumor bank both through prospective collection of samples and through the expansion of her international network of collaborators. They have sequenced 200 brain metastases with matched primary tumors and identified genetic mutations in the brain metastasis that are targetable with available drugs. These finding are now being translated to clinical trials.
What’s next: With support from BCRF, Dr. Brastianos will continue to genomically characterize tumor tissue samples from patients, with the goal of trying to understand why some patients are resistant to therapies. Tumor sequencing allows her team to reconstruct the evolutionary lineage within the primary tumor that led to the brain metastasis, thus pinpointing the key alterations that are driving metastasis. Some of these may represent novel therapeutic targets.
Dr. Priscilla Brastianos is the Director of the Central Nervous System Metastasis Program at Massachusetts General Hospital of Harvard Medical School. Originally from Vancouver, British Columbia, she received her BSc in biochemistry and chemistry from the University of British Columbia, where she graduated as her class valedictorian. She completed her medical school training at Johns Hopkins School of Medicine, and her internal medicine residency training at Johns Hopkins Hospital. Following her training at Johns Hopkins, she pursued her fellowship training at the Dana-Farber Cancer Institute and Massachusetts General Hospital. As a physician-scientist, Dr. Brastianos received a number of prestigious awards for her scholarship and research.
Dr. Brastianos’ research focuses on understanding the molecular mechanisms that drive brain metastases. Her pioneering work has led to national multicenter cooperative group trials that she is leading. She also leads a multidisciplinary central nervous system metastasis clinic at Massachusetts General Hospital. Her hope is that the findings from genomic studies will provide an understanding of the molecular pathways that drive brain metastasis, which will allow the development of more rational therapeutic approaches for this common and devastating complication of cancer.