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Priscilla Brastianos, MD

Massachusetts General Hospital
Boston, Massachusetts

Titles and Affiliations

Director, Central Nervous System Metastasis Program
Associate Professor of Medicine
Harvard Medical School
Massachusetts General Hospital
Boston, Massachusetts

Research area

Identifying new strategies for the prevention and treatment of breast cancer that has spread to the brain.

Impact

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.

Progress Thus Far

Dr. Brastianos has demonstrated the potential of a drug in a subset of patients who have brain metastases harboring defects in cell cycle regulation. She and her team have also shown that cell-free DNA—DNA fragments released from tumor cells— in cerebrospinal fluid is more effective than standard methods in the diagnosis of leptomeningeal disease, when cancer cells invade the cerebrospinal fluid and spread throughout the central nervous system. Lastly, she has made insights describing the evolution of the immune microenvironment in the central nervous system of patients receiving immunotherapy.

What’s next

In the coming year, Dr. Brastianos will continue her efforts to characterize the tumor and immune microenvironment of central nervous system metastases from breast cancer. Through national and international collaborations, Dr. Brastianos’ team is now in the process of analyzing whole exome sequencing data from several hundred breast cancer brain metastases. and has established a pipeline to perform single-cell sequencing of brain metastases and leptomeningeal disease. They will continue these efforts to characterize samples before and during therapy, which will enable them to understand what drives drug resistance in breast cancer brain metastases.

Biography

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.

BCRF Investigator Since

2017

Donor Recognition

The Boston Hot Pink Luncheon Award in Honor of Nancy and Rick Kelleher

Areas of Focus

Metastasis Tumor Biology