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Sandra M. Swain, MD
Professor of Medicine
Associate Dean for Research Development
Georgetown University Medical Center
Goal: To improve patient outcomes with the implementation of gene-based treatment management to reduce treatment-induced side effects and improve quality of life.
Impact: As more patients are living beyond breast cancer treatments, many will face long term side effects of their cancer care. Pharmacogenetics (PGx) refers to the use of genetic information to guide therapy decisions. While it is commonly used to guide the use of targeted therapy, it is not a commonly used to address survivorship issues, such as depression, anxiety, and chronic pain. Dr. Swain is initiating a pilot study to determine the feasibility and barriers of implementing PGx to improve long-term quality of life after breast cancer treatment.
What’s next: The study will enroll 100 patients with breast cancer who are not currenting receiving chemotherapy. A pharmacist trained in PGx will provide PGx-guided recommendations to the treating oncology provider. Dr. Swain’s group will observe how the clinician uses the PGx information and how it affects patient outcomes. Knowing that a lack of clinician education is often cited as a barrier to implementing PGx in the clinical setting, they will provide remote, module-based education and in-person PGx-education for clinicians.
The role of genetics in the diagnosis, prognosis, and treatment of cancer has grown rapidly over recent years. While it is commonly used to guide targeted therapy, it is not commonly used for survivorship issues. Using PGx in drug therapy decisions may help, but a lack of clinician education may be preventing the implementation of PGx. Dr. Swain is testing remote and in-person training in PGx for oncology clinicians to overcome this barrier.
Full Research Summary
Research area: Improving quality of life for patients after breast cancer with genetics-guided therapy.
Impact: As the survival rate breast cancer continues to climb, survivorship issues like depression, anxiety, and chronic pain are becoming increasingly important. Pharmacogenomics (PGx) refers to the use of genetic information to guide therapy decisions and may be helpful in decreasing treatment-induced long-term side effects. This study will assess the feasibility of implementing PGx for survivorship and provide training for oncology clinicians who are not familiar with using PGx in a clinical setting. The success of this pilot study could lead to standards of care that improve quality of life for patients treated for breast cancer.
Current investigation: Dr. Swain is embarking on a new avenue of research focused on implementing pharmacogenetics to guide drug therapy with the goal of reducing treatment-induce side effects. Such challenges—which include depression, anxiety, and chronic pain—can significantly impact quality of life and be difficult to treat. Using PGx in drug therapy decisions may be able to help.
She and her team plan to enroll 100 patients with breast cancer who are not currently receiving chemotherapy. They will study how oncology clinicians use the PGx information and how this can affect patient outcomes. A lack of clinician education is often cited as a barrier to implementing PGx in the clinical setting. Dr. Swain will provide remote, module-based education and in-person PGx-education for clinicians to address this need.
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.)