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Stuart J. Schnitt, MD
Chief of Breast Oncologic Pathology,
Dana Farber/Brigham and Women’s Cancer Center
Associate Director, Breast Oncology Program,
Dana-Farber Cancer Institute/ Brigham and Women’s Hospital
Professor of Pathology, Harvard Medical School
- Seeking biomarkers to guide treatment decisions in triple negative and BRCA-driven breast cancers.
- A clinical trial is ongoing to compare a platinum-based therapy to standard chemotherapy in patients with a mutation in the BRCA genes.
- This trial will help to determine which patients are most likely to benefit from a common drug, called cisplatin, and advance effective therapies in these aggressive breast cancers.
Mutations in the BRCA genes–drivers in hereditary breast cancer–affect the cell’s ability to repair DNA damages. While this defect leads to breast (and other forms of) cancers, it also makes BRCA-mutated cells vulnerable to treatments that cause DNA damage. Cisplatin is a commonly used chemotherapy drug that causes a type of DNA damage that BRCA-deficient cells cannot repair. Drs. Schnitt and Tung are leading a clinical trial to compare cisplatin to standard chemotherapy in women with early stage breast cancer and mutations in the BRCA genes.
Full Research Summary
Triple negative breast cancer (TNBC) comprises approximately 15 percent of all breast cancer and is the most common breast cancer type caused by mutations in the BRCA genes. The clinical management of TNBC and other BRCA-related breast cancers is challenging due to the often aggressive behavior and lack of targeted therapies
Cisplatin causes a type of DNA damage that cannot be repaired by cells that are defective in DNA repair, leading to tumor cell death. Many TNBCs and all BRCA-driven breast cancers share this defect, making cisplatin a promising therapy for these cancers. While not typically used to treat breast cancer, cisplatin has demonstrated promising results in clinical trials with breast cancer patients that are BRCA mutation carriers.
The INFORM trial (NCT01670500) is a randomized clinical trial designed to compare the relative effectiveness of cisplatin and standard chemotherapy in women with early-stage breast cancer who have inherited BRCA mutations. The trial is being conducted at the Dana-Farber Harvard Cancer Center, as well as eight sites outside of Boston, including three through the Translational Breast Cancer Research Consortium (TBCRC).
The investigators are in the process of collecting research biopsies and blood samples that will be used to determine which patients respond better to each therapy. One hundred six patients out of a target accrual of 170 are enrolled.
Stuart J. Schnitt, M.D. is the Chief of Breast Oncologic Pathology for the Dana-Farber/Brigham and Women’s Cancer Center, Associate Director of the Dana-Farber Cancer Institute/Brigham and Women’s Hospital Breast Oncology Program, co-leader of the Dana Farber Harvard Cancer Center Breast Program, Senior Pathologist at Brigham and Women’s Hospital, a Professor of Pathology at Harvard Medical School and an internationally recognized expert in breast pathology.
Dr. Schnitt did his internship and residency in Anatomic and Clinical Pathology at Beth Israel Hospital in Boston followed by a fellowship in surgical pathology, also at Beth Israel Hospital. He was a faculty member in the Beth Israel Hospital/Beth Israel Deaconess Medical Center Department of Pathology from 1984-2017, including 11 years as Director of Anatomic Pathology and subsequently Vice Chair for Anatomic Pathology. He has published over 340 original articles, review articles, editorials, commentaries, and book chapters, primarily in the area of breast diseases. He has authored a popular breast pathology textbook entitled “Biopsy Interpretation of the Breast”, now its third edition. The first two editions of this book were also published in Chinese. In addition, he is one of the editors of the 4th Edition of the “World Health Organization Classification of Tumours of the Breast”, published in 2012.
Dr. Schnitt is a Past President of the United States and Canadian Academy of Pathology (2010-2011). Other notable honors include the Arthur Purdy Stout Society of Surgical Pathologists Annual Prize (1999), the Albany Medical College Distinguished Alumnus award (2014), the Lynn Sage Distinguished Lecturer (2014) and the Maude Abbot Lecture at the United States and Canadian Academy of Pathology Annual Meeting (2016). He is particularly proud to have been involved in the training of 35 breast pathology fellows since 1995. He has lectured extensively around the world. His research interests and contributions to our understanding of benign breast diseases and breast cancer have been broad, but have largely focused on risk factors for local recurrence in patients with invasive breast cancer and ductal carcinoma in situ treated with breast conserving therapy, benign breast disease and breast cancer risk, and stromal-epithelial interactions in breast tumor progression.