Goal: To understand the variation in the course of breast cancer in different women

Impact: Dr. Rennertis collecting the world’s largest series of newly diagnosed breast cancer patients (almost 10,000 patients) with full clinical annotation and molecular characterization. This allows them study various aspects of disease behavior including response to treatment, recurrence of tumor, and overall survival. With a large enough series, they can identify markers to predict recurrence that lead to change in treatment and more personalized care.

What’s next: Dr. Rennertwill continue to recruit new patients (and healthy matched controls) while continuing to follow-up with the already enrolled women. They will continue to analyze the genetic data they have gathered to identify patterns in the clinical behavior of breast cancer between different groups.

Goal: To improve response to immunotherapy in triple negative breast cancer (TNBC).

Impact: Dr. Gianni has advanced the understanding of how chemotherapy given before surgery can trigger the immune system to attack and eliminate TNBC tumors. This work, along with his research of biomarkers that could predict response to immunotherapy, may help determine which patients would benefit from chemotherapy alone and those who would have a better response to a combination of chemotherapy and immunotherapy.

What’s next: He and his team will launch a clinical trial in patients with early high-risk and locally advanced TNBC. They will compare the effects of adding an immunotherapy drug (atezolizumab) with chemotherapy versus chemotherapy alone. In clinical trials, immunotherapy has shown some success in treating TNBC. However, the response rate is low, which may be due to the lack of a biomarker that would help doctors predict which patients may benefit from this targeted form of therapy. Dr. Gianni is studying methods to identify those most likely to respond to a type of immunotherapy called immune-checkpoint inhibitors and those who will do well with chemotherapy alone.

Goal: To identify new strategies for the prevention and treatment of metastatic breast cancer.

Impact: Dr. Merajver has discovered that a specialized immune cell—the M2a macrophage—promotes cancer progression and encourages tumor growth. This will allow her and her team to investigate new ways to prevent metastasis. They’ve also made advances in predicting which breast cancer cells are capable of forming brain metastases and built a research platform to test cancer cells directly from surgeries and biopsies to help guide treatment.

What’s next: She and her team will study live cancer cells from patients from different ethnic groups in the U.S. who experience a high burden of triple negative and inflammatory breast cancer to find out whether small aggressive cancers have the potential to spread to other sites in the body. While most early stage breast cancers have a very good prognosis, others spread to other organs—a process called metastasis. While there are treatments that can extend the lives of those with metastatic breast cancer, it is incurable, so identifying ways to prevent metastasis would save many lives. Dr. Merajver’s group is using devices that allow them to study how cancer cells migrate to different tissues in the body, which may reveal methods for preventing this process from occurring.

Goal: To develop novel strategies for breast cancer imaging and image-guided therapy.

Impact: Dr. Emelianov and his team have created new medical imaging devices and agents to detect, differentiate, treat, and monitor breast cancer and lymph node metastases. Such technology will help provide a comprehensive approach to the clinical management of breast cancer.

What’s next: The team’s investigations will be focused on the imaging of regional lymph nodes of breast cancer patients. The involvement of regional lymph nodes in the disease is considered to be a strong predictor of recurrence and survival. When patients undergo breast cancer therapy, imaging is used to determine whether the cancer has spread to other tissues so that treatment plans can be adjusted to prevent metastasis. Dr. Emelianov is studying advanced imaging methods that provide highly detailed information about cancer cells, which will help him develop an imaging platform capable of non-invasive and safe diagnostic imaging and image-guided therapy of breast cancer, a technology called theranostics.

Goal: To identify protein and gene biomarkers that will improve risk assessment in women at high risk of developing breast cancer.

Impact: Drs. Cuzick and Francis are expanding their high-risk breast cancer biobank, which is a collection of blood and tissue samples, mammograms, and clinical data from women enrolled in breast cancer prevention and treatment trials. This resource will help them determine which types of breast cancer will respond to different kinds of preventive treatment.

What’s next: The team will collaborate with researchers around the world to collect samples and data from women taking part in several ongoing trials. While large randomized clinical trials may provide clues for predicting response to therapy or late recurrence, the results don’t apply to every participant because individual responses are influenced by the patient’s and the tumor’s unique genetic profile. By gathering samples and data from women enrolled in clinical trials, Drs. Cuzick and Francis hope to identify biomarkers that will help them understand why some patients respond to therapy and others do not, and to identify patients at high risk of recurrence.

Goal: To identify protein and gene biomarkers that will improve risk assessment in women at high risk of developing breast cancer.

Impact: Drs. Francis and Cuzick are expanding their high-risk breast cancer biobank, which is a collection of blood and tissue samples, mammograms, and clinical data from women enrolled in breast cancer prevention and treatment trials. This resource will help them determine which types of breast cancer will respond to different kinds of preventive treatment.

What’s next: The team will collaborate with researchers around the world to collect samples and data from women taking part in several upcoming trials. While large randomized clinical trials may provide clues for predicting response to therapy or late recurrence, the results don’t apply to every participant because individual responses are influenced by the patient’s and the tumor’s unique genetic profile. By gathering samples and data from women enrolled in clinical trials, Drs. Francis and Cuzick hope to identify biomarkers that will help them understand why some patients respond to therapy and others do not, and to identify patients at high risk of recurrence.

Goal: Developing a new, blood-based screening tool for detecting breast cancer.

Impact: Dr. Brewster and her team developed a new technology capable of detecting exosomes, which are small particles secreted from cancer and other cells. This could provide a more nuanced method to detect breast cancer.

What’s next: The team will conduct a study to evaluate the performance and reliability of this technology, with a focus on evaluating how well detection of breast cancer exosomes can predict breast cancer risk in individuals of different races and ethnicities. If successful, the results can set the stage for a larger study to determine if an individual with a positive blood test for breast cancer exosomes should be offered more frequent screening, including breast MRI, while a someone with a negative blood test can safely be advised to have less frequent screening mammograms or no screening at all.

Goal: Identifying genetic markers to help select the right therapy for patients with hormone receptor-positive breast cancer.

Impact: Approximately one million patients per year are diagnosed globally with estrogen receptor (ER)–positive breast cancers, which rely on estrogen to grow. They typically receive tamoxifen or aromatase inhibitors (AIs), which interfere with hormone signaling. However, some patients do not respond well to these therapies, and some stop treatment due to intense side effects. Drs. Wang and Ingle study how a patient’s genetic makeup may affect their tolerance of and response to these therapies so that the most helpful drugs can be selected.

What’s next: The team will explore if alterations in specific genes coincide with differences in a patients’ response to therapy.

Goal: Identifying genetic markers to help select the right therapy for patients with hormone receptor-positive breast cancer.

Impact: Approximately one million patients per year are diagnosed globally with estrogen receptor (ER)–positive breast cancers, which rely on estrogen to grow. They typically receive tamoxifen or aromatase inhibitors (AIs), which interfere with hormone signaling. However, some patients do not respond well to these therapies, and some stop treatment due to intense side effects. Drs. Wang and Ingle study how a patient’s genetic makeup may affect their tolerance of and response to these therapies so that the most helpful drugs can be selected.

What’s next: The team will explore if alterations in specific genes coincide with differences in a patients’ response to therapy.

Goal: Identifying ways to boost the immune response in breast cancer patients to improve chemotherapy outcomes.

Impact: Metastatic triple-negative breast cancer (mTNBC)-cancer that has spread beyond the breast to other organs of the body-has few treatment options and is therefore very difficult to cure. Dr. Disis and her team are addressing this challenge by developing combination approaches utilizing immunotherapy and chemotherapy. They developed a vaccine called STEMVAC which can recognize multiple breast cancer antigens, tested it in a Phase I clinical trial, and optimized the vaccine and dosing schedule. They are now examining the efficacy of using the STEMVAC alone and in combination with chemotherapy in laboratory models of NBC. The team has also created a novel vaccine called ADVac (adipocyte-directed vaccine) for further development.

What’s next: Dr. Disis and her team will continue their studies to uncover potential biomarkers that could be used to assess the response of patients to the combination of immunotherapy and chemotherapy. They will continue preclinical testing of the STEMVAC-chemotherapy combination to define a clinic-ready treatment regimen and set the state for phase 2 clinical trials. They will also continue to characterize ADVac and pursue studies to advance STEMVAC for use in the clinic with the goal of providing alternative strategies for treating patients with mTNBC who are becoming resistant to chemotherapy and at high-risk of recurrence.