Judy E. Garber, MD, MPH

2012-2013 BCRF Project:
(made possible with generous support from Coach)

In 2012-2013, Dr. Garber's group continues to build on one of their findings that had resulted from BCRF support. The investigators had observed that aggressive breast cancers in women with BRCA1 or BRCA2 mutations are sensitive to chemotherapy containing platinum agents. The reporting of these observations has led some oncologists to begin using platinums in the treatment of women with BRCA mutations based on data by this team and others. To ascertain that response to platinum is not just a surrogate for response to any cytotoxic chemotherapy, in 2011-2012, Dr. Garber's team launched a randomized phase II neoadjuvant trial (chemotherapy before surgery) in which women with BRCA1/2 associated high grade breast cancers (HER2-negative) will receive either cisplatin or the standard combination chemotherapy of doxorubicin plus cyclophosphamide (AC) for four cycles (or until progression if sooner), then undergo standard surgery and subsequent standard adjuvant therapy at the discretion of their treating physician. The researchers began to assess the ability of these treatments to cause a "pathologic complete response, that is, disappearance of all tumors so that none is found at the time of surgery in the breast or the lymph nodes. Several other research teams, many of whom are also BCRF investigators, have joined this effort to address this important question.

During the last year, Dr. Garber's team also wrote the protocol to evaluate whether preoperative cisplatin chemotherapy is superior to standard chemotherapy in women with inherited BRCA1 mutations and newly diagnosed breast cancer. This trial is known as the INFORM: BRCA1/2 trial. In addition, they have established the necessary relationships with several academic centers across the country that will participate in the trial. The protocol is now being reviewed by the Scientific Review Committee and Institutional Review Board at Dana-Farber Harvard Cancer Center. It is anticipated that the trial will open for enrollment in early fall 2012.

Mid-year Progress: The INFORM trial is underway. In this multi-center trial, Dr. Garber's research group is comparing preoperative cisplatin chemotherapy to the standard chemotherapy (cyclophosphamide/doxorubicin) in women with inherited BRCA1 mutations and newly diagnosed breast cancer. The trial is based on a previous trial funded by BCRF that was the first to show that cisplatin, an established chemotherapeutic agent used in the treatment of ovarian cancer and other tumors but not breast cancer, might have exceptional activity in breast cancers occurring in women with inherited BRCA1/2- associated risk. The study has opened at the Beth-Israel Deaconess Medical Center and Dana-Farber Cancer Institute in Boston. Two patients have enrolled into the study, and the research group is awaiting activation of the protocol at our collaborating sties at academic centers across the country.

Bio:
Dr. Garber is the Director of the new Cancer Genetics and Prevention Disease Center at Dana-Farber Cancer Institute and a Professor of Medicine at Harvard Medical School. She founded the Friends of Dana-Farber Cancer Risk and Prevention Clinic, one of the first devoted to the identification and management of individuals at highest cancer risk. The program formed the basis for the new disease center, and is a major referral center for clinical care and research in inherited cancer risk, clinical trials of cancer preventive interventions and cancer genetic counseling models. To foster the incorporation of cancer genetics into clinical practice, Dr. Garber has played a major role in the development of national guidelines in genetics (American College of Medical Genetics) and medical oncology (American Society of Clinical Oncology and National Comprehensive Cancer Network.) Her research activities have been continuously funded by National Institutes of Health and private foundations and include the study of breast cancer risk assessment and communication, cancer genetics more broadly, and pharmacogenetics. She is also a leader in research into the characteristics and treatment of triple negative or basal-like breast cancer, the most common form in women with BRCA1 mutations. Her translational research focuses on the evaluation of novel agents targeting DNA repair defects in breast cancer, including PARP inhibitors for treatment and prevention of breast cancer and other BRCA-associated cancers.

Dr. Garber is past President of American Association for Cancer Research, the largest organization of cancer researchers in the world. She is a member of the National Cancer Institute Board of Scientific Counselors and chairs the External Advisory Board of the SPORE in Breast Cancer at MD Anderson Cancer Center and is a member or chair of the Data Safety Monitoring Committees of several international breast cancer clinical trials. She is a member of the Scientific Advisory Board of The Breast Cancer Research Foundation. Locally, she co-chairs a Dana-Farber/Harvard Cancer Center Institutional Review Board panel D, and is a member of the Personalized Cancer Medicine Partnership Steering Committee and the Executive Committee for Clinical Research.