Joseph A. Sparano, MD

To improve treatment outcomes and reduce the risk of breast cancer recurrence by identifying biomarkers to inform treatment decisions, as well as to advance the understanding of invasive lobular carcinomas.

Impact

Working under the auspices of the Coalition of Cancer Cooperative Groups and ECOG-ACRIN Breast Committee, BCRF investigator, Dr. Joseph Sparano is leading efforts to advance the clinical management of breast cancer by utilizing resources collected as part of ongoing clinical trials to identify biomarkers that can better inform treatment decisions. Blood and tissue samples from breast cancer patients who take part in clinical trials are a valuable resource for researchers. They reveal details about the nature of the disease and can also be used to discover biomarkers that help inform personalize treatments and reduce side effects. Dr. Sparano oversees ongoing data analysis of samples from the Late-Relapse Repository and ECON-ACRIN trials to identify and validate markers from patient tissue and blood to improve personalized treatment approaches and outcomes for breast cancer patients. Part of his ongoing work is the characterization and evaluation of invasive lobular cancer in ECOG-ACRIN Phase III breast cancer trials. Invasive lobular breast cancer (ILC) is the second most prevalent type of the disease, arising in the milk-producing glands of the breast. Dr. Sparano’s research in ILC is essential to understand the many subtypes of breast cancer. He hopes these studies will provide much-needed insight into this understudied form of breast cancer.

Progress Thus Far

ECON-ACRIN trials are increasingly focused on strategies to individualize breast cancer care. Results have shown that there are genetic markers that may indicate a patient is at higher risk of neuropathy when treated with chemotherapy. And the ECOG-ACRIN led TAILORx trial validated a gene-based test to predict which patients can safely forego chemotherapy after hormone treatment for breast cancer. Other ECOG-ACRIN studies, demonstrated that circulating tumor cells (CTCs)—tumor cells that have escaped the tumor and entered the circulation—in the blood of patients with early-stage breast cancer was associated with an 18. 3 percent increased risk of breast cancer recurrence. Dr. Sparano’s team is steadily expanding their biorepository of ILC samples that now contains over 22,000 patient samples. Analysis of these samples as well as those obtained from patients who experienced a late relapse (5 or more years) after breast cancer treatment are ongoing.

What’s next

Dr. Sparano will lead efforts to evaluate biomarkers that can help identify patients with early-stage breast cancer who are at risk of recurrence. In addition, analysis of data from several ECOG-ACRIN breast cancer treatment trials will continue including studies in patients with metastatic and triple-negative breast cancers, assessing the best mammographic screening modality for healthy women, and identifying patients at risk of aromatase inhibitor-induced musculoskeletal symptoms.