November 28, 2017--(BRONX, NY)--Researchers at Albert Einstein College of Medicine, part of Montefiore, and Hackensack Meridian Health John Theurer Cancer Center at Hackensack University Medical Center have secured a five-year, $6.4 million grant from the National Institutes of Health (NIH) to identify biomarkers that can predict which women with pre-cancerous tissue in their breast will develop invasive breast cancer. This research could help personalize treatment and improve outcomes for tens of thousands of women each year.
Ductal carcinoma in situ (DCIS)--increasingly detected thanks to the widespread use of mammography--is a precursor of invasive breast cancer (IBC). Approximately 50,000 women are diagnosed with the disease each year. When untreated, between 14 and 53 percent of patients develop IBC in the three decades following diagnosis. Unfortunately, it's not possible to tell which DCIS patients will go on to develop IBC. As a result, individual women are often over- or under-treated--either suffering debilitating radiation or chemotherapy treatments they do not need, or skipping potentially life-saving therapies.
"A diagnosis of DCIS presents patients with a difficult and stressful dilemma in terms of how to treat the condition," says co-principal investigator Thomas Rohan, M.B.B.S., Ph.D., D.H.Sc., professor and chair of epidemiology & population health and the Harold and Muriel Block Chair in Epidemiology and Population Health at Einstein. "A clinical test that could help accurately predict a patient's prognosis would be enormously helpful and provide some much needed direction for settling on a plan of care."
As part of their effort to develop a prognostic test for IBC risk, Einstein and Hackensack University Medical Center researchers will evaluate a promising experimental assay that measures the expression of three genes-- p16, COX-2, and Ki67--implicated in cell proliferation. They will also instigate novel research into microRNAs, noncoding RNAs that regulate gene expression and are thought to contribute to the development of invasive cancer.
Such markers might also help improve treatment for women found to be at high risk for IBC--by leading, for example, to novel agents that target molecular changes associated with invasive-disease development.
"We have concentrated our efforts on developing state-of-the-art molecular tools to better understand the natural history of Ductal Carcinoma in situ (DCIS) lesions, with hope to complement current histological and immunohistochemical assays and improve personalized prognostic for women diagnosed with this disease" says co-principal investigator Olivier Loudig, Ph.D., formerly of the department of epidemiology & population health at Einstein, and now an associate scientist at John Theurer Cancer Center at Hackensack University Medical Center, and member of the Georgetown Lombardi Comprehensive Cancer Center.
Researchers will use clinical data and archived tissue samples from a cohort of more than 7,000 patients diagnosed with DCIS and who were followed to see if they later developed IBC. They will evaluate the samples to identify and validate miRNA expression changes associated with risk for subsequent IBC; evaluate risk of IBC in association with two previously identified sets of markers, including Oncotype DX DCIS score; and examine the association between clinical factors and risk for subsequent IBC.
The grant, titled "Molecular markers of risk of subsequent invasive breast cancer in women with ductal carcinoma in situ," was awarded by the National Cancer Institute, part of the NIH (R01CA218429).
About Albert Einstein College of Medicine
Albert Einstein College of Medicine, part of Montefiore, is one of the nation's premier centers for research, medical education and clinical investigation. During the 2017-2018 academic year, Einstein is home to 697 M.D. students, 181 Ph.D. students, 108 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,900 full-time faculty members located on the main campus and at its clinical affiliates. In 2017, Einstein received more than $174 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit www.einstein.yu.edu , read our blog, follow us on Twitter, like us on Facebook and view us on YouTube.