Susan E. Clare, MD, PhD

2008-2009 BCRF Project:
(made possible by generous support from One-A-Day® Women's Multivitamins)
Co-Investigator: Anna Maria Storniolo, MD, Indiana University School of Medicine

Why do patients suffer recurrence after receiving optimal treatment? Drs. Clare and Storniolo hypothesize that it is a delivery problem; it is because the treatment is unable to reach a fraction of cells which lie too far from the nearest blood vessel. As these cells are distant from the vascular supply, they also do not receive enough oxygen. The lack of sufficient oxygen is called hypoxia. The body's response to hypoxia is to recruit immune cells, called monocytes, to the tumor and more specifically, to the areas of hypoxia. Once there, the monocytes become macrophages and act as enablers of the malignant breast cells; for example they help recruit a blood supply to the tumor.

The researchers have proposed to use the macrophages as a Trojan Horse to deliver therapy to hypoxic areas of breast tumors. The therapy to be delivered are gold-silica nanoshells which are smaller than 1/1,000 the width of a human hair. These nanoshells have the property of transforming light energy into heat. By irradiating the nanoshells, they hypothesized that the heat would destroy the tumor enabling macrophages as well as their neighboring malignant breast cells. The study will continue through the coming year.

Mid-year Progress Report:
The purpose of this project is to develop a strategy to treat breast tumor cells which reside in a region of the tumor far away from the nearest blood vessel and consequently do not receive adequate systemic therapy. The idea is to place anti-tumor therapy in cells of the immune system which are recruited by the tumor to these areas far from the blood supply. Since the therapy is contained within these cells, they act as a Trojan horse.

The initial therapeutic is a particle made of gold and glass that is 1/1000 the size of a human hair. These particles have the property of being able to transform light into heat, and the heat acts to kill the tumor cells in the neighborhood of the gold and glass particles. These particles can also be coated with drugs, which can be released by shining light onto the particles. Theoretically, this will result in a high concentration of drug in the tumor producing greater efficacy locally, and a much lower concentration of drug in the circulation leading to fewer side effects.

Bio:
Dr. Clare is Assistant Professor, Division of Breast Surgical Oncology, Department of Surgery, Indiana University School of Medicine. She is also a Guest Scientist/Visiting Professor at the Universitäts-Frauenklinik, Tübingen, Germany. She received a BA (Biology), MS (Chemistry) and PhD (Chemistry) from Northwestern University, Evanston, Illinois. Dr. Clare is an Alpha Omega Alpha graduate of Northwestern University Medical School, Chicago, IL. Following completion of an internship and residency in general surgery at Northwestern, Dr. Clare was a postdoctoral fellow in the laboratory of Patricia S. Steeg, PhD, Women's Cancers Section, Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland.

Dr. Clare's current laboratory research interests include a) The utilization of nanovectors for the treatment of breast cancer, b) Progenitor cells and the development of the normal breast, and c) The effect of surgical extirpation of a primary breast cancer on the growth of micrometastatic disease present at the time of operation. Dr. Clare is an active member of the Translational Breast Cancer Research Consortium. She is a member of the Clinical Advisory Board of the Cincinnati/Purdue/University of Illinois at Urbana-Champaign Nanomedicine Development Center.

Dr. Clare and her colleagues, Anna Maria Storniolo, MD and Connie Rufenbarger, Consumer Representative, Catherine Peachey Fund, Inc., continue to develop the Susan G. Komen® for the Cure Tissue Bank at the IU Simon Cancer Center; a biorepository of breast tissue and biospecimens from women without clinical evidence of breast cancer. The Bank can be accessed on the Web at: https://komentissuebank.iu.edu.