Titles and Affiliations
Professor of Medicine
Associate Dean for Research Development
Research area
Understanding the role of the estrogen receptor in resistance to HER2-directed therapies in triple-positive breast cancer.
Impact
Fifty percent of HER2-postive breast cancers also have estrogen and progesterone receptors (ER and PR) and are therefore called triple-positive breast cancer (TPBC). Trastuzumab (Herceptin®) and pertuzumab (Perjeta®) are very effective HER2-targeted treatments, but TPBCs are less responsive to these drugs before surgery—this means that patients have worse outcomes. . Researchers have shown that HER2-directed therapies result in the relocation of HER2 from the cell membrane to the nucleus of the cell where iy associates with DNA and regulates genes involved in growth and metastasis.. Dr. Swain is investigating the connection between the nuclear HER2 and the expression of novel “ER target” genes and outcomes in patients with TPBC with high tumor expression of these genes.
What’s next
Dr. Swain’s approach is three-pronged: First, they will analyze clinical trial tumor samples to see if expression of the previously identified ER target genes can predict anti-HER2 treatment response. Second, using an independent set of patient tissue samples, they will determine whether the presence of nuclear HER2 is linked to expression of these specific ER target genes. Lastly, they will test whether blocking the function of these ER target genes makes TPBC cells more sensitive to anti-HER2 treatments in laboratory models. Since TPBCs represent a significant portion of HER2-positive cases, understanding how anti-HER2 treatment directs HER2 to the nucleus and changes the behavior of ER will help to identify new therapeutic targets or combination treatments that could improve response to anti-HER2 treatment.
Biography
Dr. Sandra M. Swain is an internationally-recognized breast cancer medical oncologist, and clinical translational researcher. She has authored nearly 300 articles in numerous peer-reviewed medical journals, such as the New England Journal of Medicine, Lancet Oncology, and the Journal of Clinical Oncology, on topics including inflammatory breast cancer, adjuvant treatment of breast cancer, the treatments of metastatic HER2-positive breast cancer, cardiotoxicity, and health care disparities.
Throughout her career, Swain has held many advisory and leadership positions with professional oncology societies and organizations across the globe. From 2012 through 2013, she served as President of the American Society of Clinical Oncology where she championed efforts to promote the advancement of women in medicine and that she continues today through her service on the board of Conquer Cancer, the ASCO foundation, and the Women Who Conquer Cancer initiative she established. Currently, she is a professor at the Georgetown University School of Medicine, the Associate Dean for Research Development at Georgetown University Medical Center, and the Vice President of MedStar Genetic Medicine–roles in which she works to improve patients’ access to cutting-edge treatments and technologies by expanding medical research opportunities across the MedStar Health system. She is also co-chair of the Early Breast Cancer Trialists’ Collaborative Group in Oxford and a visiting professor of clinical oncology at the University of Oxford, UK.
