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Rena Feinman, PhD
Associate Scientist, Department of Research
Hackensack University Medical Center
Hackensack, New Jersey
Seeking to identify innovative approaches to improve response to therapies for triple negative breast cancer.
A clinical study is conducted to measure changes in the gut microbiome before, during and after treatment in patients with triple negative breast cancer to identify biomarkers that can predict response to therapy.
This study may identify new biomarkers that can inform future studies.
The bacteria that inhabit our gut play vital roles in health and diseases, including cancer. Scientists are studying the gut microbiome to understand its role in cancer development, as well as how the cancer responds to therapy. Triple negative breast cancer (TNBC) is an aggressive disease treated primarily by chemotherapy, but many patients do not respond to the treatment. Drs. Feinman and Montgomery are studying changes in the gut microbiome after chemotherapy treatment in patients newly diagnosed with TNBC to identify markers than may predict how patients will respond to chemotherapy.
Full Research Summary
Triple negative breast cancer (TNBC) is an aggressive heterogeneous disease accounting for 15-20 percent of all breast cancers. Although significant progress has been made in our understanding of the disease, there remains no targeted therapy and only 30 percent of TNBC patients respond to neoadjuvant (pre-surgery) chemotherapy.
Drs. Feinman and Montgomery are conducting studies prompted by the recent discovery that the gut microbiome, consisting of tens of trillions of bacteria, contributes to the variability in immune response to cancer therapies. They hope to determine whether distinct gut microbial communities increase the efficacy of chemotherapies by re-activating the immune system to eradicate TNBC tumor cells.
In their BCRF-supported research, Drs. Feinman and Montgomery will correlate changes in the composition of the gut microbiome with anti-tumor immune response in newly diagnosed TNBC patients before, during, and after standard neoadjuvant chemotherapy.
Preliminary results of patient stool samples suggest that loss of bacterial diversity and alterations in the composition of the gut microbiome are primarily associated with the use of anthracyline-based chemotherapy. Microbiome diversity was restored after taxane-based chemotherapy.
The researchers hope to identify novel biomarkers within the microbiome that can predict response to chemotherapy. Ultimately, they aim to find clues of how to optimize therapeutic strategies to improve outcomes for patients with TNBC.
Dr. Rena Feinman is an Associate Scientist in the Department of Research and Member of the John Theurer Cancer Center at Hackensack University Medical Center. She received her PhD in the Department of Microbiology at the New York University School of Medicine and pursued her postdoctoral fellowship at Memorial Sloan Kettering Cancer Center.
While on faculty at the Myeloma Institute for Research and Therapy in Little Rock, Arkansas, Dr. Feinman’s laboratory identified NFkappaB, a master regulator of immune and inflammatory responses, as a therapeutic target and predictive factor in clinical response to dexamethasone and immunomodulatory-based therapies in multiple myeloma patients.
Until 2013, Dr. Feinman was an Assistant and Associate Professor of Surgery at Rutgers-New Jersey Medical School. Her research investigated how hypoxia-inducible factors (HIF) and toll-like receptor signaling triggered intestinal inflammation during shock and critical illness led to the development of systemic inflammatory response syndrome and multiple organ failure.
Dr Feinman’s current research examines the influence of the gut microbiome in modulating anti-tumor immune responses in high-risk multiple myeloma. In collaboration with Dr. Leslie Montgomery, Dr. Feinman is working to identify novel gut flora-associated biomarkers that predict response to chemotherapy, disease-free survival and overall survival in newly diagnosed TNBC patients.