Priscilla Brastianos, MD
Director, Central Nervous System Metastasis Program
Associate Professor of Medicine
Harvard Medical School
Massachusetts General Hospital
Identifying new strategies for the prevention and treatment of breast cancer that has spread to the brain.
Breast cancer that spreads to the brain occurs in more than a third of patients with advanced breast cancer. While advances in cancer therapies have improved our ability to control breast cancer outside of the brain, more breast cancer patients are dying of brain metastases. The prognosis of cancer patients who develop brain metastasis is poor, with only 20 percent of patients surviving at one year. The genetic and molecular drivers of metastasis are largely unknown. The overarching objective of Dr. Brastianos’ work is to characterize the genetic changes in brain metastases that will shed light on their fundamental biology and to ultimately identify novel therapeutic targets. Dr. Brastianos hopes to quickly translate her team’s scientific findings to innovative clinical trials for patients with breast cancer brain metastases.
In a study published in Nature Medicine, Dr. Brastianos reported results demonstrating that patients with leptomeningeal carcinomatosis—a devastating complication of breast cancer that has spread to the brain and spinal cord—experienced longer survival times with immunotherapy. Based on findings from BCRF-supported research, she and her team launched a clinical trial to test the CDK4/6 inhibitor palbociclib (IBRANCE®) in patients with brain metastases that have genetic alterations in the CDK pathway. Early results of the trial have shown that more than 50 percent of patients benefit from CDK inhibition, which is remarkable for this patient population. This work has resulted in the initiation of a national brain metastasis clinical trial that is now activated at more than 300 sites throughout the United States.
In the upcoming year, Dr. Brastianos will continue to identify novel therapeutic targets for central nervous system (CNS) metastases. She and her team have developed a pipeline that allows them to study brain metastases at unprecedented resolution. Using advanced genetics techniques, they can distinguish the cell types and cell states comprising the tumor-immune microenvironment of brain metastases. In addition, they will use a technology that allows them to read information about the immune landscape of each patient sample directly from genomic DNA.
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.
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