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W. Fraser Symmans, MD
Professor of Pathology
Director of Research Operations
University of Texas MD Anderson Cancer Center
Goal: To identify breast cancer patients who are at risk of recurrence.
Impact: Dr. Symmans is testing a predictive assay to identify patients with hormone receptor-positive breast cancer and metastatic breast cancer who will respond to hormone therapy. If successful, this tool would allow for more precise treatment decision-making and improve outcomes for patients with aggressive and advanced breast cancers.
What’s next: He and his team will continue to test the accuracy of this gene-based assay.
The goal of precision medicine is to match the right drugs to the right patient based on several factors, including the individual’s genes. While many advances have been made in this area of research, more work needs to be done in order to bring precision medicine to the clinic. Dr. Symmans has developed a promising assay that may identify patients with advanced breast cancer most likely to respond to endocrine therapy.
Full Research Summary
Research area: Developing gene-based prognostics tests to improve on current technologies used to guide treatment decisions for patients with estrogen receptor-positive breast cancer.
Impact: Most breast cancers are driven by hormones, particularly estrogen. These cancers, referred to as estrogen receptor (ER)-positive, are treatable with anti-hormone (endocrine) therapies. As breast cancers progress, however, they often lose sensitivity to endocrine therapy. This is particularly true in breast cancers that have spread to other tissue – a processes called metastasis. Dr. Symman’s BCRF research is testing a gene-based assay to predict which patients with metastatic or late-stage breast cancer are likely to respond to endocrine therapy. The assay uses advanced technology that will be an improvement over existing assays and aid in the clinical management of ER-positive breast cancer.
Current investigation: Dr. Symmans is developing a series of gene-based tests referred to as SET (Sensitivity to Endocrine Therapy) that can be used to guide treatment decisions in patients with metastatic (stage IV) or regional (stage II-III) breast cancer.
What he’s learned so far: He and his colleagues have shown the SET assay to be accurate in patients with Stage II or III primary breast cancer and for patients with metastatic breast cancer and have confirmed that it outperforms existing prognostic signatures.
What’s next: Based on promising predictive results for patients with stage II or III, ER-positive breast cancer, Dr. Symmans’ team will continue testing the SET assay in different conditions prior to advancing it to a prospective clinical trial. They continue to validate the SET assay on existing tumor samples obtained from clinical trials in patients with ER-positive breast cancer. In addition, Dr. Symmans and his colleagues will determine if the duration of chemotherapy affects the sensitivity to subsequent endocrine therapy as measured by the SET assay.
Dr. Fraser Symmans is Professor and Director of Research Operations in the Department of Pathology at MD Anderson Cancer Center, where he practices Breast Surgical Pathology and Cytopathology and also directs the Breast Cancer Pharmacogenomics Laboratory. He received his medical degree from the University of Auckland, New Zealand, completed his residency at Columbia University, New York, and fellowship at MD Anderson Cancer Center, Houston. Dr. Symmans joined the faculty of New York University Medical Center in 1993 and moved to MD Anderson Cancer Center in 2000. Dr. Symmans’ research is focused on breast cancer, with specific emphasis on neoadjuvant (pre-operative) treatment trials for evaluation of chemosensitivity and development of diagnostic tests to select the most effective treatments for individuals with breast cancer. This research program has led to the development of predictive molecular tests that are currently being evaluated in a prospective clinical trial. His other ongoing research is addressing the effects of biopsy sample quality on genomic test results in order to establish appropriate best practices for clinical diagnostic use. Additional responsibilities include: Co-Chair for the Translational Breast Cancer Research Consortium, Director of Translational Research Program for the Alliance clinical trials group, and member of the Breast Cancer Steering Committee for the National Clinical Trials Group.