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Prudence Francis, MBBS, B Med Sc, FRACP, MD
Head of Medical Oncology, Breast Service
University of Melbourne
Goal: To identify protein and gene biomarkers that will improve risk assessment in women at high risk of developing breast cancer.
Impact: Drs. Francis and Cuzick are expanding their high-risk breast cancer biobank, which is a collection of blood and tissue samples, mammograms, and clinical data from women enrolled in breast cancer prevention and treatment trials. This resource will help them determine which types of breast cancer will respond to different kinds of preventive treatment.
What’s next: The team will collaborate with researchers around the world to collect samples and data from women taking part in several upcoming trials.
Full Research Summary
Research area: Seeking to improve breast cancer risk assessment in high-risk women by identifying protein and gene biomarkers.
Impact: Well-designed randomized clinical trials can provide vital information about prevention strategies and effective treatments for women at risk of or diagnosed with breast cancer. However, the results apply to the trial group as a whole—not necessarily to every woman in it. Because individual responses to breast cancer therapies are influenced by the patient’s and the tumor’s unique genetic profile, the information provided by clinical studies is limited.
To address this issue, Drs. Francis and Cuzick are collecting and analyzing biological samples and clinical data from participants in large clinical trials to identify risks for individual women based on protein and gene biomarkers that can predict outcomes for the prevention and treatment of breast cancer.
Current investigation: The team is expanding their High-Risk Breast Cancer Biobank (HRBCBB), which includes blood, tumor tissue, and mammograms, as well as clinical outcome data and long-term follow-up of individual women in prevention and treatment trials.
What they’ve learned so far: In the last year, Drs. Francis and Cuzick have updated the follow-up of IBIS-I and IBIS-II, including a pathology review that will show whether the benefits of aromatase inhibitors are maintained beyond five years as they were for treatment with tamoxifen. This continued follow-up is necessary to evaluate the impact of preventive therapy on death from breast cancer.
What’s next: As new trials such as EXPERT, CHARIOT and DIAmOND are conducted and a new cohort study PRIMROSE is set up, biospecimens from participants in these investigations will be collected and added to the HRBCBB, further expanding this resource for future translational research.
Prue Francis is Clinical Head of Breast Medical Oncology at Peter MacCallum Cancer Centre in Melbourne, Australia. She received her medical degree from the University of Melbourne and completed Medical Oncology training at Memorial Sloan-Kettering Cancer Center in New York, where she spent 4 years. Since returning to Australia she focused her research on breast cancer randomized clinical trials (i.e. BIG 2-98, SOFT) with prospective tissue collection to facilitate translational research. She chairs the Steering Committee for the SOFT and TEXT trials which have led to changes in adjuvant endocrine therapy recommendations for young women with hormone receptor-positive breast cancer.
Dr Francis is Chair of the Scientific Advisory Committee of Breast Cancer Trials Australia & New Zealand (BCT-ANZ) which has been conducting clinical trials since 1978. The multidisciplinary group has enrolled more than 15,000 women in national and international clinical trials across the disease spectrum from breast cancer prevention, DCIS, early stage disease, and neoadjuvant therapy, through to advanced breast cancer trials. The group trials variously involve escalation or de-escalation strategies, with an emphasis on biobanking, and quality of life assessment.
Dr Francis is a member of the St. Gallen International Expert Consensus Panel on the Primary Therapy of Early Breast Cancer, and the Advanced Breast Cancer (ABC) International Consensus Panel. She is a member of the Scientific Committee of the International Breast Cancer Study Group (IBCSG) and a member of the Breast International Group (BIG). In 2015 she was awarded the Medical Oncology Group of Australia Cancer Achievement Award.