5 women taking down breast cancer

Date

10.12.17

CategoryLife

These innovators are developing vaccines, technology, and more ways to fight the disease.

This year, breast cancer awareness month kicked off with some encouraging news: A new report from the American Cancer Society found that breast cancer death rates in the U.S. fell by 39 percent from 1989 to 2015. Women have had more opportunities to fight back due to earlier detection, better screening, and more effective treatments. But this type of cancer continues to touch a lot of lives—it’s estimated that more than 250,000 American women will be diagnosed in 2017—so scientists are continuing to look for innovative solutions to better spot, manage, and treat cancer. Women are spearheading some of the biggest developments, and their game-changing research is laying the groundwork for new therapies in fields like genetics, optics, and vaccines.

Ahead, we spoke with some of the leading female scientists who are making a difference in breast cancer research today.

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Jana Kainerstorfer, Ph.D.
Her big idea: Kainerstorfer, an assistant professor of biomedical engineering at Carnegie Mellon University, is developing a first-of-its-kind portable handheld device that can give doctors more information about breast lesions to figure out next steps for treatment.
Why it’s important: If a woman feels a new lump or doctors need to keep tabs on an existing one, the standard procedure is to do an imaging test such as a mammogram or MRI. While these tests reveal the size and density of a lesion, they’re not always conclusive, which means that if a lesion looks suspicious, the patient will likely need a biopsy.
Soon, we may be able to get more information with less testing and fewer invasive biopsies. Like a mammogram or ultrasound, Kainerstorfer’s device would give doctors information about the shape, size, and location of a lump—and then go one step further. “It shines near-infrared (red) light into the tissue which can tell us how much blood is in the area,” she explains. “Red light isn’t absorbed as much as other colors, especially by blood, so the darker the resulting image, the more blood there is. Tumors need blood supply to survive and the more blood they have, the more malignant they are,” she explains. “So by getting information about how much blood there is around a lesion, we can determine how malignant it is.”
This new device is slated to be in clinical trials in the spring, and Kainerstorfer is excited about its potential. "I could see women using it at home and sending the images to their doctor for review," she says. “I don’t think the patient would be interpreting their results, but I like the idea of involving patients more in their own care.”
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Jennifer Keating Litton, M.D
Her big idea: Litton, an associate professor of breast medical oncology at the University of Texas MD Anderson Medical Center, is developing ways to treat tumors without chemotherapy.
Why it’s important: Last year, Litton tested a cancer drug called a PARP inhibitor on 13 women who had early stage breast cancer and the BRCA mutation. “On average, women’s tumors shrank by about 70 percent in just two months,” she says. “In fact, because we had such an amazing response, we stopped the trial ahead of schedule and presented the results.”
Patients typically get chemotherapy to reduce their tumors, but Litton’s study shows that patients with a BRCA mutation might be able to skip it or receive less. “I think chemo works. I give it every day. But it looks like in some cases, if we use the drug as early as possible, we can pull back on chemotherapy and kill tumor cells without it,” she explains.
Litton found that the BRCA mutation blocked off a pathway that cancer cells used to repair and grow, so the cells found a different one, which required the enzyme PARP. “The drug we tested blocks that enzyme so the cancer cells cannot repair themselves and die off,” she says.
Next up, Litton will reveal results of a study testing the drug in women with BRCA mutations and metastatic breast cancer, which she says is really promising. “We could be getting this therapy to people years before it otherwise would,” she says.
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Nikita Wright, Ph.D. and Maureen Murphy, Ph.D.
Their big idea: Wright, a student at Georgia State University and Murphy, a professor and program leader of the Molecular and Cellular Oncogenesis Program at the Wistar Institute in Philadelphia, are digging into why African-American women fare worse with breast cancer.
Why it’s important: Despite the steady decrease in breast cancer deaths, African-American women are still hit harder than other populations. They’re more likely to die from breast cancer at an early age and more likely to get aggressive forms of the disease. Doctors are a bit stumped about why this happens but Wright and Murphy might have some answers.
Earlier this year, Wright’s team was the first to make a new connection: When African-American breast cancer patients received chemotherapy before surgery—called neoadjuvant chemotherapy—it was less likely that their tumors would return. “Neoadjuvant chemotherapy is often given to patients with large tumors or locally advanced breast cancer,” Wright explains. “Our study encourages doctors to administer it to African-American patients regardless of their tumor size or presence of locally advanced disease. Considering that African-American women have a higher risk of tumors coming back, this could address the disparity that exists in breast cancer.”
Wright’s team also found that African-American women with triple negative breast cancer who had high levels of nuclear KIFC1, a type of biomarker, tended to die sooner or had poorer survival rates. Interestingly, white women weren’t affected by it, whether their levels were high or low. “This was the first study to find a genetic racial disparity in breast cancer,” she says. “And now that we know about this difference, we can use drugs that address this biomarker, potentially saving thousands of lives.”
Murphy’s work—which is independent of Wright’s—found that premenopausal African-American women with a variant of the p53 gene had an 80 percent higher chance of developing breast cancer. “One out of 40 African-American women have this variant, and this study was the first to make the connection and could potentially explain why African-American women are more likely to get more aggressive cancers,” she says.
The link is a huge breakthrough: “As far as we can tell, p53 is the first gene to sense that a cell is dividing when it is not supposed to, and it shuts that cell down,” she says. “It also controls most of the response to conventional chemotherapy and radiation therapy, so if you have a tumor, and that tumor has mutated or deleted p53, then you have a much, much poorer prognosis.”
The next step is finding a drug that specifically targets it. “We found two drugs that kill tumors with the variant well in mouse models, so we hope to move to human testing soon.”
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Mary L. Disis, M.D.
Her big idea: Disis, a professor of medicine and part of the University of Washington’s Tumor Vaccine Group, is developing a vaccine for breast cancer.
Why it’s important: A vaccine is one of the most sought after innovations for cancer, and it’s not surprising why. “If you’re able to generate immunity against cancer cells, it can last a lifetime,” says Disis. Unlike lung or skin cancer, breast cancer doesn’t produce a good immune response against the disease, so a vaccine could give patients an extra boost to help fight it. Disis estimates we could have the vaccine in five to eight years, and she currently has a few in the works that she’s testing in humans after successful trials in mice.
One tackles HER2 receptors, which about 25 percent of breast cancers have too much of (also known as HER2 positive breast cancer). The excess makes breast cells divide uncontrollably and Disis hopes the vaccine will eliminate all the cells that have too many of these receptors, thereby killing all cancer cells. About 20 years ago, she was part of the research team that discovered that the immune system is capable of responding to HER2 and has since been working on ways for the immune system to get better at recognizing it. “Currently, the body doesn't see HER2 as an invader. The immune system recognizes that it is there and is abnormal, but not abnormal enough for it to be killed,” she explains. “The key is trying to make the immune response see HER2 as dangerous.”
The other vaccine targets stem cells, which researchers think are present in all types of breast cancers. “These cells are really resistant to chemotherapy and are really the ones responsible for cell death,” she says. “This vaccine would be more universal and could help a variety of different patients.” What's more, Disis thinks a vaccine to prevent breast cancer (for people who have never had it) is possible in the next five to eight years. She tested the stem cell vaccine in mice and found it was able to prevent breast cancer in some.
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