Kathy S. Albain, MD, FACP
Director, Breast Clinical Research Program
Co-Director, Breast Oncology Center
Director of the Thoracic Oncology Program
Professor of Medicine, Stritch School of Medicine
Dean’s Senior Scholar
Loyola University Chicago
2013-2014 BCRF Project:
(The Housewares Charity Foundation Award)
Estrogen receptor-positive (ER+), HER2-negative (HER2-) breast cancer is the most common subtype in women diagnosed with early stage breast cancer. Endocrine therapy (tamoxifen or aromatase inhibitors, AIs) after definitive surgery has resulted in significantly decreased mortality from breast cancer. However, there are many breast cancers that are either resistant to endocrine therapy right at the start or become resistant duringtreatment. Oncologists currently have no good strategies to overcome this resistance. Cancer stem cells drive the growth of breast cancers and these cells, unlike the rest of the breast tumor, are resistant to standard treatments. Notch signaling (a complex of many genes) is a key “driver” of stem cell survival and growth, and this pathway is intimately related to estrogen signaling pathways. A novel class of drugs called gamma secretase inhibitors (GSIs) inhibit Notch activation and genes subsequently targeted by Notch, which in turn inhibit survival of cancer stem cells, leading to cancer cell death. In laboratory models, combining endocrine therapy with a GSI resulted in significantly better tumor shrinkage. As a first test of this exciting discovery in humans, Drs. Albain and Osipo completed a “biomarker modulation” trial of adding a GSI to endocrine therapy for a short period before surgery. The women donated biopsy material at three time points to allow the investigators to conduct experiments on which genes are increased and/or decreased by the GSI to prove that the Notch pathway is shut down. At the end of this project, Drs. Albain and Osipo aim to identify a “Notch/stem cell gene signature” and propose its use in definitive clinical trials designed to test that Notch inhibitors such as GSIs in combination with standard endocrine therapy might provide more cures for women with estrogen receptor-positive breast cancer.
Drs. Albain and Osipo report exciting results from the first 3 months of this project. They identified 14 genes that are impacted significantly by the gamma secretase inhibitors (GSI), in other words are either turned on or turned off by the GSI. The 3 genes that are turned on promote the death of cancer cells. The 11 genes that are turned off include genes that regulate Notch signaling, cancer stem cells, and growth, plus new genes and pathways. A bioinformatician is currently working on defining how Notch signaling regulates these multiple genes and pathways. This will complete Aim 1, so the researchers are on track with their timeline. In February they will progress to work on Aim 2, to identify a “Notch/stem cell gene signature”. This signature will be used in definitive clinical trials with endocrine therapy and GSIs to hopefully result in more cures of women with ER positive breast cancer.
Dr. Kathy S. Albain, FACP is Professor of Medicine at the Stritch School of Medicine of Loyola University Chicago, and was granted tenure in 2005. Dr. Albain is a Dean’s Senior Scholar. She is a member of the Division of Hematology/Oncology and devotes her clinical practice to patients with breast and lung cancer at Loyola’s Cardinal Bernardin Cancer Center on the campus of the Loyola University Medical Center. She is Director of its Breast Clinical Research Program, Co-director of the multidisciplinary Breast Oncology Center, and Director of the Thoracic Oncology Program.
Dr. Albain is involved in national research and advisory activities pertaining to breast and lung cancers as well as cancer survivorship and special populations research. She chaired the Committee on Special Populations for the Southwest Oncology Group (SWOG), a National Cancer Institute-sponsored cancer clinical trials cooperative group, from its inception. This committee conducted novel research initiatives that addressed gender differences in cancer, survivorship issues, and the outcome and treatment of special populations such as older persons with cancer and ethnic minorities. An active lay advocates program was formed under her leadership. She was recognized for over a decade of this work in 2003 with the Susan G. Komen Professor of Survivorship award. Dr. Albain then served as co-chair of the new SWOG Cancer Survivorship Committee through 2010. She is now co-chair of the Breast International Group-North American Breast Cancer Group (BIG-NABCG) Survivorship Working Group. She has over 165 publications in peer-reviewed journals and major textbooks.
Dr. Albain is a member of SWOG’s working groups for breast and lung cancer and has devoted her career to research in both diseases. She is a member of the international Early Breast Cancer Trialists’ Collaborative Group and its Steering Committee. She served on the National Cancer Institute Concept Evaluation Panel for lung cancer. She was a charter member of the NIH Committee on Research on Women’s Health and completed a four-year term on the Oncologic Drugs Advisory Committee of the FDA, followed by service as a consultant to the FDA Center for Drug Evaluation and Research. Dr. Albain is the founding Vice President of the National Lung Cancer Partnership and a current member of its Board of Directors. She is a Fellow of the American College of Physicians
She is a summa cum laude graduate of Wheaton College in Wheaton, Illinois, and graduated from the University of Michigan Medical School. Dr. Albain received her postgraduate training in Internal Medicine and then Hematology/Oncology at the University of Illinois and University of Chicago, respectively. She is a member of Grace Evangelical Lutheran Church in River Forest, IL and sings in its Senior Choir.