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Sandra M. Swain, MD
Professor of Medicine
Associate Dean for Research Development
Georgetown University Medical Center
- Seeking to improve outcomes in advanced HER2-positive breast cancer by reducing resistance to targeted therapies.
- Analysis of patient tumors is conducted to identify predictors of response to therapy.
- These studies may identify genetic profiles to aid in treatment decisions for patients with HER2-postive breast cancer.
HER2-targeted therapies have dramatically improved outcomes for patients with HER-positive breast cancer, but not all patients benefit from the therapy. Identifying patients who are not likely to benefit will allow clinicians to pursue other treatment options. Dr. Swain is conducting studies to identify signals of response in tumors collected as part of several clinical trials of HER2-positive breast cancer.
Full Research Summary
HER2 targeted therapies including traztuzumab, lapatinib and others have significantly improved outcomes for this group of patients and changed HER2-positive breast cancer from a cancer with very poor prognosis to one with a favorable prognosis. However, resistance to these therapies remains a serious clinical challenge.
Patients with HER2 positive breast cancer are very likely to respond well to targeted therapy and chemotherapy prior to surgery, called neoadjuvant therapy. The neoadjuvant therapies allow clinical researchers to evaluate tumors for specific biomarkers that predict those patients in whom current therapies are likely to be successful and those in whom recurrence it likely to occur.
Dr. Swain's group previously completed a neoadjuvant trial, NSABP B41, which compared several treatments in the neoadjuvant setting in patients with HER2-positive breast cancer. Over the last year, her team conducted molecular analysis of the tumors in this study to identify which women were most likely to benefit from HER2-targeted therapy. In this analysis, they found that patients whose tumors were classified as HER2-enriched were more likely to respond to neoadjuvant HER2 therapy.
In the coming year, her goal is to combine clinical and genetic profile data from several studies, some of which were supported by BCRF, to definitively describe the specific profile for which HER2-targeted therapy delivers the best outcomes.
These studies will be important for discovery for additional treatments for HER2-positive breast cancer and help to tailor treatment to individual patients
Sandra M. Swain, MD, FACP is the Medical Director of the Washington Cancer Institute, MedStar Washington Hospital Center, in Washington, DC. She is a Professor of Medicine at Georgetown University and Adjunct Professor of Medicine at F. Edward Hebert School of Medicine. She was previously the Deputy Branch Chief of the Medicine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health and was a tenured Principal Investigator and Chief of the Breast Cancer Section and of the Cancer Therapeutics Branch. She obtained an undergraduate degree in Chemistry from the University of North Carolina in 1975, and a MD from the University of Florida in Gainesville in 1980. She completed her residency in internal medicine at Vanderbilt University in 1983 followed by a fellowship in Medical Oncology at the National Cancer Institute in 1986.
Dr. Swain’s research interests include clinical trials and translational research in metastatic and inflammatory breast cancer, adjuvant therapy for breast cancer, cardiotoxicity, and health care disparities. Her research has been funded by the National Institutes of Health, Susan G. Komen Foundation, Breast Cancer Research Foundation, and the Avon Foundation. She has published over 230 articles and is recognized as a leading international figure in breast cancer. She received the Susan G. Komen for the Cure Community Global Award of Distinction in 2012. Dr. Swain was president of the American Society of Clinical Oncology (ASCO) in 2012-13, served as a member of the ASCO Board and is a member of the Conquer Cancer Foundation Board.
BCRF Investigator Since
The ANN INC. Award (a division of ascena retail group inc.)