Lisa A. Carey, MD

In recent years, researchers have developed a novel classification system for breast cancer that differentiates tumors into four major categories: luminal A, luminal B, HER2 positive, and triple negative. Tumors within a category share biological and genetic characteristics that seem to dictate patient prognosis, tumor progression, and treatment effectiveness. The current classification system is based primarily on the expression of 50 genes that in some ways overlap the accepted classification scheme in breast cancer (estrogen receptor, HER2, etc.) but add additional information when compared with the use of just these receptors.

In 2012-13, Dr. Carey and her colleagues will investigate the benefit of the current gene expression array classification system. They will also assess newer sequencing-based methods by performing them on samples from patients enrolled in their studies whose comprehensive disease, treatment, and survival data have been recorded.

Mid-year Progress: The heterogeneity of breast cancer that is just now beginning to be understood includes the fact that breast cancer is not one disease but is a heterogeneous mixture of biologically distinct subtypes. Within these subtypes are variations in growth, survival, and behavior that are poorly understood. In this study, Dr. Carey's team is using comprehensive profiling to examine signatures of proliferation and growth, nutrient availability, and other signatures within the major groups of breast cancer in a study of new breast cancer diagnoses among North Carolina women. For those treated with preoperative therapy for HER2-positive disease, the researchers will perform more in-depth mutation analysis of the tumors to identify the elements of the cancer that are the most relevant for response to HER2-targeted therapy. This effort will help the researchers understand the biology of breast cancer in the community, and to identify predictors of response to HER2- targeted treatment that can be studied in the recently completed National Cancer Institute trial, CALGB 40601.

Bio:
Lisa A. Carey, MD is the Richardson and Marilyn Jacobs Preyer Distinguished Professor in Breast Cancer Research in the UNC Department of Medicine, Division of Hematology-Oncology. She graduated from Wellesley College in 1984 with a bachelor's degree in Biology and Art History. She received her medical degree from the Johns Hopkins University School of Medicine in 1990. She remained at Johns Hopkins for her residency in Internal Medicine followed by a fellowship in Medical Oncology and an advanced degree in Clinical Investigations. Dr. Carey joined the UNC faculty and Lineberger Comprehensive Cancer Center in 1998. In 2012, she was appointed Chief of the Division of Hematology-Oncology and Physician-in-Chief of North Carolina Cancer Hospital. Dr. Carey is Medical Director of the UNC Breast Center.

Dr. Carey has a longstanding research interest in the clinical application of laboratory findings in breast cancer, with a particular interest in the clinical implications of different molecular subtypes of breast cancer. She designs and leads clinical trials of novel drugs and approaches, and is a close collaborator with several laboratory investigators and epidemiologists. Dr. Carey has served on the American Society of Clinical Oncology (ASCO) Scientific Program and Education Committees and as faculty for ASCO and AACR-CTRC San Antonio annual meetings for many years. She was awarded a Doris Duke Clinician Scientist Award in 1999, a Career Development Award from the National Cancer Institute (NCI) in 2000, and was inducted into the Johns Hopkins Society of Scholars in 2008. In 2011 Dr. Carey was awarded the National Cancer Institute Director's Service Award.