Triple-negative and inflammatory breast cancer research
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among women. Triple-negative (TN) and inflammatory breast cancers (IBC) are the most aggressive forms of the disease.
Many patients will not recur, but 15-20% of breast cancer patients remain at high recurrence risk.
Our lab seeks to identify which TN and IBC patients will have recurring disease, discover new targets for therapy, and develop treatments that are more effective.
Over 13 years of experience investigating circulating tumor cells (CTCs) in stage I-III breast cancer patients has contributed to these efforts. Our lab has obtained serial blood draws on more than 830 breast cancer patients to date.
Recently, we have focused our liquid biopsy breast cancer research on individual patient blood samples obtained from high-risk patients who do not have disease that has spread to distant sites.
Often, TN and IBC patients do not have tumor tissue available at diagnosis, and researchers are not able to obtain metastatic tumor tissue.
Our published studies show that a significant number of TN and IBC patients have CTCs in their blood that predicts recurrence. We also learned that CTCs have targets that are different from their primary tumors.
One protein, HER2, may be present in CTCs, but not in that same patient’s tumor. Therefore, TN patients with HER2+ CTCs might receive benefit from currently approved anti-HER2 drugs.
We have found cancer cell DNA (ctDNA) is often times altered in the blood of cancer patients making them resistant to chemotherapy.
By measuring ctDNA in the blood before, during, and after chemotherapy, we can characterize the specific DNA mutations. These DNA “signatures” can predict if/when a patient will become resistant to treatment, and identify/test potential inhibitors of this DNA machinery.
Stage II-IV cutaneous and uveal melanoma research
Tumor characteristics and cancer lymph nodes are tools doctors currently use to stage patients and estimate risk of recurrence.
Despite the development of new targeted and immune therapies to treat melanoma, many patients either do not respond to these therapies, or develop resistance to therapy within a short period of time (6-8 months).
There are currently no blood tests available to help doctors accurately tell which patients are likely to relapse (and should be given therapy) and which are low risk (and should just be observed), or how a patient’s cancer cells become resistant to targeted and immune therapies.
Our research laboratory first started investigating circulating melanoma cells (CMCs) in stage II-IV melanoma patients in late 2012 and we have already obtained serial blood draws on more than 800 melanoma patients to date.
Our first CMC paper, published in 2015, was the first to show that CMCs could be detected in 30-45% of stage II-IV patients.
We have learned that using CMCs can more effectively manage advanced stage (stage III and IV) melanoma. Our stage III CMC data included 243 newly diagnosed stage III patients.
As with our breast cancer data, one CMC predicted disease progression better than many of the parameters doctors currently use in the clinic to predict which patients will recur.