Associate Professor, Medicine
Division of Oncology
Section of Medical Oncology
Washington University School of Medicine
St. Louis, Missouri
Estrogen receptor positive (ER+) breast cancer in postmenopausal women is a major public health problem. Although the majority of these cancers are treatable with anti-estrogen (endocrine) treatment and chemotherapy, up to 20% of patients will recur with metastatic disease (development of new tumors at distant sites). On the other hand, many patients would have been cured with endocrine treatment alone and could be spared the toxicities of chemotherapy. A major task is therefore to develop biomarkers that identify those breast cancers most likely to respond to anti-estrogen therapies vs. those that are resistant.
BCRF has provided critical support for National Cancer Institute-sponsored Cooperative Group neoadjuvant trials in women with ER+ breast cancers (where treatment is administered before tumor surgery). In addition to providing critically important information to guide the development of individualized treatment strategies and targeted therapies for this patient population, these studies also generate a rich source of tumor material to investigate why some tumors are resistant to treatment. One such trial is the ALTERNATE tria, conducted under the auspices of the Alliance for Clinical Trials in Oncology (Alliance), one of the NCI cooperative groups. This Phase III neoadjuvant treatment trial is designed to validate and discover ways to predict tumor responsiveness to endocrine therapy and to uncover novel therapeutic targets for ER+ breast cancer. Dr. Ma is working with BCRF colleagues, Matthew Ellis and Monica Bertagnolli, Chair or the Alliance, on separte projects within the ALTERNATE trial. The overarching objective of her project with Dr. Ellis is to molecularly classify endocrine therapy resistant tumors so that new approaches can be developed to reduce the recurrence rate. This research has the promise to change the clinical management of ER+ breast cancer and lead to more personalized treatments.
The goal of her joint project with Dr. Bertagnolli is to be able to develop a drug-response score that can be used to predict which tumors can forego subsequent chemotherapy. The ALTERNATE trial combines the use of anti-estrogen therapy prior to surgery with biomarker measurements to identify those tumors most sensitive to the endocrine treatment. The biomarkers will be used to generate a score that reflects the rate of tumor growth, tumor size, and lymph node involvement. Results from the study will help to identify which patients can avoid chemotherapy following anti-estrogen treatment, reducing unnecessary toxicities and improving quality of life.
Dr. Cynthia Ma obtained her MD from Beijing Medical University in China and subsequently PhD in Developmental Biology from the University of Cincinnati. She completed her Internal Medicine residency from New Hanover Regional Medical Center at North Carolina followed by the Hematology/Medical Oncology fellowship at Mayo Clinic, Rochester, Minnesota. In 2005, she was recruited as a breast oncologist at Washington University School of Medicine (WUSM). She is currently an Associate Professor of Medicine and a research member of Siteman Cancer Center. In August 2014, Dr. Ma was appointed as the Clinical Director of the Breast Cancer Program at WUSM. Dr. Ma’s research includes preclinical and clinical trial development of molecularly targeted cancer therapeutics for the treatment of resistant breast cancer. She is the principal investigator for several biomarker directed clinical trials of biological agents including UCN-01, temsirolimus, MK2206, BKM120, IMC-A12, and palbociclib in breast cancer.