Eric P. Winer, MD
Chief, Division of Women's Cancers
Thompson Senior Investigator in Breast Cancer Research
Professor of Medicine, Harvard Medical School
Co-Chair, Breast Committee of the Alliance for Clinical Trials in Oncology
Dana-Farber Cancer Institute, Boston, Massachusetts
2013-2014 BCRF Project:
(The ANN INC. Award)
Co-Investigator: Nancy U. Lin, MD, Dana-Farber Cancer Institute, Boston, MA
Among women with metastatic breast cancer, 10% to15% will eventually develop brain metastases (cancer that has spread to the brain). In patients with more aggressive tumor subtypes (for example, HER2-positive or triple negative), the risk of brain metastases may reach as high as 25 to 46 percent. Treatment options for patients with breast cancer and brain metastases are limited, and very few drugs have been tested in this setting. Over the past several years, with support from the BCRF, Drs. Nancy Lin, Eric Winer, and colleagues have completed multiple clinical trials to test potential new treatments for patients with advanced breast cancer, including patients with cancer that has metastasized (spread) to the brain. Recently, they reported data from a phase 2 clinical trial testing the role of bevacizumab (Avastin) given in combination with conventional chemotherapy. They found that that over 60% of patients experienced significant tumor shrinkage in the brain metastases and that many of the responses were long-lasting. Based on these promising results, Drs. Lin and Winer are planning a large phase 3 clinical trial to test the value of bevacizumab in this patient population who have few standard treatment options. They have also nearly completed enrollment to a clinical trial of the oral HER2-blocking medicine, neratinib, in patients with breast cancer brain metastases and anticipate the first results may be available within the next year. Finally, in collaboration with other researchers in the context of the EMBRACE (Ending Metastatic Breast Cancer for Everyone) cohort study, Drs. Lin and Winer have developed several new laboratory models for breast cancer brain metastases and are in the process of testing combinations of novel targeted treatments, with the goal of identifying the most promising combinations to push forward into clinical testing.
Drs. Eric Winer, Nancy Lin, and colleagues are taking a multi-pronged and multi-disciplinary approach to evaluate mechanisms of resistance to currently available treatments and to translate those findings to clinical trials, including, but not limited to, patients with cancer that has metastasized (spread) to the brain. The research team has created multiple new laboratory models derived from human tumor tissues collected at the time of surgery, including models specifically designed to test novel drug combinations in the setting of HER2-positive breast cancer and brain metastases. The team is also testing two different targeted combinations in clinical trials for patients with brain metastases. As a new project over the past year, BCRF funding is allowing the research team to continue to build the EMBRACE study, which is a registry study for patients with metastatic breast cancer, designed to capture information about patients’ treatments and response to treatments as well as permission to study their tumor issues, in order to learn from all patients, regardless of whether or not they are participating in a clinical trial of new treatments. The scientific goal of the study is to study important clinical questions with human tissue specimens. Examples of such questions include why and how tumors become resistant to hormonal therapies, why trastuzumab (Herceptin) works extraordinarily well in some patients but not others, etc. To date, the study has enrolled 600 women and men living with metastatic breast cancer, and it is anticipated that the study will provide a rich resource for scientific inquiry in the years to come.
Dr. Eric P. Winer is Professor of Medicine at Harvard Medical School and Chief, Division of Women's Cancers and the Thompson Senior Investigator in Breast Cancer Research at Dana-Farber Cancer Institute. He is also Co-Chair of the Breast Committee of the Alliance for Clinical Trials in Oncology. Dr. Winer has devoted his professional career to the treatment of individuals with breast cancer and breast cancer research. He has designed and led phase I, II, and III clinical trials. Dr. Winer has collaborated closely throughout his career with psychosocial, health services, basic, and translational researchers. He is the Principal Investigator of the Dana-Farber/Harvard Cancer Center SPORE in Breast Cancer.
Dr. Winer is a graduate of Yale College, with a degree in History and Russian/East European Studies. He subsequently obtained his medical degree from Yale School of Medicine, followed by training in internal medicine at Yale. He completed a fellowship in medical oncology at Duke University Medical Center and remained on the Duke Faculty until 1997, when we moved to Dana-Farber Cancer Institute in Boston to assume the role of Director of the Breast Oncology Center.