Stuart J. Schnitt, MD

2012-2013 BCRF Project:
(made possible with generous support from The Housewares Charity Foundation)
Co-Investigator: Nadine Tung, MD, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston

Breast cancer that develops in women with inherited mutations in the BRCA1 or BRCA2 genes comprises approximately 5% of all breast cancer and 10% of breast cancer in Ashkenazi Jewish women. Previous data suggest that women with BRCA1 mutations preferentially develop triple negative breast cancer, and a subset of women with triple negative disease without BRCA mutations would also have DNA-repair-deficient triple negative breast cancer. As a result, with BCRF support, Drs. Tung and Schnitt conducted the first neoadjuvant ("pre-operative") trials using cisplatin, which is platinum-containing chemotherapy, in women with triple negative breast cancer. They tested cisplatin because data had demonstrated the agent to be especially effective on BRCA1 deficient triple negative breast cancer cells. Based on that data, Drs. Tung and Schnitt have partnered with other BCRF grantees in 2011-2012 to conduct a multi-institutional clinical trial to determine whether BRCA-associated breast cancers are more effectively treated with cisplatin, an agent that targets defects in DNA repair, than with standard chemotherapy. During the last year, they have completed writing 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, Drs. Tung and Schnitt 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 a few months.

In addition, Drs. Tung and Schnitt have also completed collecting clinical information on women with triple negative breast cancer to evaluate whether those with an inherited BRCA1 mutation have a different prognosis than women without a mutation. They are currently also evaluating whether certain features of the pathology of triple negative breast cancers can predict a better or worse prognosis.

Mid-year Progress: During the previous six months, the protocol to evaluate whether preoperative cisplatin chemotherapy is superior to standard chemotherapy in women with inherited BRCA mutations and newly diagnosed breast cancer has been approved by the Institutional Review Board of the Dana-Farber Harvard Cancer Center and has opened to accrual at the Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute. This trial is known as the INFORM: BRCA1/2 trial. The first two patients have been enrolled. In addition, several collaborating academic centers across the country are in the process of opening the trial.

Drs. Tung and Schnitt have also begun analysis of the data collected on 264 women with triple negative breast cancer to evaluate whether those with an inherited BRCA1 mutation have a different prognosis than women without a mutation and whether brain metastases are more common in these women.

Bio:
Dr. Stuart Schnitt is an internationally recognized expert in breast pathology. He did his internship and residency in Anatomic and Clinical Pathology at Beth Israel Hospital in Boston followed by a fellowship in surgical pathology, also at Beth Israel Hospital. He joined the pathology staff at Beth Israel Hospital in 1984 and has spent his entire career at Beth Israel Hospital /Beth Israel-Deaconess Medical Center and Harvard Medical School. He is currently Director of the Division of Anatomic Pathology at Beth Israel Deaconess Medical Center, a consultant in pathology at Brigham and Women's Hospital and the Dana-Farber Cancer Institute, and a Professor of Pathology at Harvard Medical School. In April, 2010, Dr. Schnitt was inducted as president of the United States & Canadian Academy of Pathology (USCAP), an organization of nearly 11,000 physician pathologist members worldwide. Read the >>full press release

Dr. Schnitt has published over 240 original articles, review articles, editorials, commentaries, and book chapters, primarily in the area of breast diseases. Along with Dr. Laura Collins, in 2009 he published a breast pathology textbook entitled "Biopsy Interpretation of the Breast". He currently serves on the editorial board of 13 journals. He has received the Arthur Purdy Stout Society of Surgical Pathologists Annual Prize (1999) and the Golden Microscope Award for Resident Teaching and Mentoring at Beth Israel Deaconess Medical Center (2003). He has been cited in multiple editions of The Best Doctors in America and America's Top Doctors. In addition, he will serve as President of the United States and Canadian Academy of Pathology in 2010-2011. His research interests have focused primarily on risk factors for local recurrence in patients with invasive breast cancer and ductal carcinoma in situ treated with breast conserving therapy, benign breast disease and breast cancer risk, and stromal-epithelial interactions in breast tumor progression.