Judy E. Garber, MD, MPH

Dr. Garber's trial of platinum as treatment for women with triple negative breast cancer has given rise to a second trial that has accrued 85% of its target group to date, and the researchers are ready to submit for IRB review an exciting multi-center trial that they developed and led comparing platinum toplatinum plus the new PARP inhibitors, a class of drugs that have early efficacy in women with BRCA1 and BRCA2 mutations and advanced ovarian and breast cancers. Dr. Garber is conducting this trial with a number of other BCRF investigators (Drs. Baselga, Carey, Tung, Livingston, Olopade and Perou).

Her team also continues to study the breast tumors from women in the platinum trials to search for new targets for therapy, and new markers with which to predict response to current treatments. They have been studying familial lobular breast cancer, and have assembled 141 specimens promised for analysis of the CDH1 gene, which has been linked to lobular breast cancers and hereditary gastric cancers. Their specimens again come from BCRF collaborators (Offit, Domchek, Brown, Ford, Olopade). They should have an answer later this year as to whether this gene identifies another group of women at hereditary risk for lobular breast cancers, which should be easier to prevent than to detect.

For their most recent project, studying progesterone receptor in the normal breast tissue of women with BRCA1 mutations as a target for preventive therapies, as of early June the researchers had identified 74 specimens for analysis and have been retrieving them from the pathology departments at the original institutions, and have developed the procedures for collecting fresh tissue and RPFNA specimens for analysis. Despite the passage of over a decade since the cloning of BRCA1 and the publication of thousands of papers, very little is known about the actual process of tumor formation in the breasts of mutation carriers. The demonstration by Dr. Max Wicha’s group that ALDH1 positive acini may mark areas of initial and critical steps in malignant transformation in the breasts of BRCA1 mutation carriers creates an opportunity to substantially improve our understanding of this important problem.

Dr. Garber’s project for the coming year will explore the properties of ALDH1 positive cells in the context of BRCA1 or BRCA2 heterozygosity. Her specific aims approach these issues using an array of techniques and both clinical and laboratory approaches to improve understanding of the significance of these cells.

Mid-year Progress Report:
Dr. Garber continues to work in hereditary breast cancer and triple negative disease. Her group's first neoadjuvant trial of platinum for women with triple negative breast cancer gave rise to a second trial that has completed accrual. Based on their exciting results, the researchers have begun the Phase I trial combining platinum and an exciting new agent, a PARP inhibitor, that has shown exciting early results in women with BRCA1 and BRCA2 mutations and advanced ovarian and breast cancers. Once the doses are established, they will submit for IRB review a multi-center trial that Dr. Garber developed and led comparing platinum to platinum plus the new PARP inhibitors, a class of drugs Her team is conducting this trial with a number of other BCRF investigators (Drs. Baselga, Carey, Tung, Livingston, and Domchek).

They also continue to study the breast tumors from women in the platinum trials to search for new targets for therapy, and new markers with which to predict response to current treatments. They have been studying familial lobular breast cancer, and have analyzed 141 specimens promised for analysis of the CDH1 gene, which has been linked to lobular breast cancers and hereditary gastric cancers. Their specimens again come from BCRF collaborators (Offit, Domchek, Brown, Ford, Olopade). Early results of the analysis suggest that CDH1 mutations only rarely underlie familial lobular breast cancer in the absence of diffuse gastric cancer. The researchers are in the midst of their collection and analysis of progesterone receptor in the normal breast tissue of women with BRCA1 mutations as a target for preventive therapies. They are also actively collecting fixed and frozen tissue samples from women undergoing prophylactic mastectomies for their BRCA1 or BRCA2-associated breast cancer risk for the researchers’ most recent study of ALDH1 stem cells as potential markers of breast cancer evolution in mutation carriers. Dr. Garber's laboratory collaborator, Dr. Silver, continues to investigate the role of BRCA1 in both DNA repair and differentiation.

Bio:
Dr. Garber is Director of the Cancer Risk and Prevention Program at the Gillette Center for Women's Cancers at Dana-Farber Cancer Institute. She is also an attending physician at Dana-Farber's Breast Evaluation Center, an associate physician at Brigham and Women’s Hospital and an associate professor of Medicine at the Harvard Medical School. Dr. Garber's research is focused on genetic susceptibility to breast, ovarian and other cancers, and the development of novel medical strategies to prevent cancer. She uses the tools of cancer epidemiology and biostatistics, genetics and molecular biology to identify women at high risk for breast cancer.

Dr. Garber has been at Dana-Farber Cancer Institute since 1988 when she joined the faculty after completing a fellowship in Medical Oncology at DFCI and fellowships in Cancer Epidemiology and Biostatistics at the National Cancer Institute and DFCI.

A graduate of the University of Virginia, Dr. Garber earned her medical degree and her master's degree in public health from Yale University School of Medicine and completed her internship and residency at Brigham and Women's Hospital and the Brockton-West Roxbury Veteran's Administration Medical Center.